We report a 4-month-old male presenting with hypocalcemia, hyperleukocytosis, and newly diagnosed acute myeloid leukemia. He received chemical leukoreduction through low-dosed cytarabine, with appropriate decrease in his white blood cell count and development of subsequent symptomatic hypocalcemia, which did not normalize until the underlying vitamin D deficiency was addressed. A single dose of cholecalciferol raised the serum calcium concentration to an appropriate level within 48 hours. For infants with newly diagnosed leukemia and prolonged hypocalcemia, vitamin D deficiency should be considered in the differential diagnosis and managed appropriately.
Departments of *Pediatric Hematology and Oncology
§Oncology, St Jude Children’s Research Hospital, Memphis, TN
†Department of Pharmacy Practice, St Louis College of Pharmacy, St Louis, MO
‡Department of Pediatric Endocrinology, Sanford Children’s Specialty Clinic, Sioux Falls, SD
This work was approved by the authors’ institutional review board.
Supported by the American Lebanese Syrian Associated Charities.
C.C. and V.B. are co-lead authors.
The authors declare no conflict of interest.
Reprints: Raul C. Ribeiro, MD, Department of Oncology, St Jude Children’s Research Hospital, 262 Danny Thomas Place, MS 721, Memphis, TN 38105-3678 (e-mail: firstname.lastname@example.org).
Received November 5, 2012
Accepted February 20, 2013