Protocol About Doing SR/ionized Calcium in Hospitalized Neonates

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katihar...

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	Specialist Answers
Question
Hello, i want to know about protocol (by iap/nnf/other authority/aims) about doing SR/ionized calcium in hospitalized neonates & treatment of it. Does every preterm and LBW need oral/iv calcium though the reports are normal? till when?
Answer
From the history, he seems to be a steroid dependent nephrotic syndrome (i.e. he requires a low dose of steroid constantly to maintain remission). Since he has already received lot of steroids and levamisole does not seem to work, the best option would be to put him on cyclophosphamide as a steroid sparing agent. Long term high dose steroids have lot of side effects such as cataracts, brittle bones, high blood pressure, muscle weakness etc. To prevent these complications and also maintain him in remission for a longer time, cyclophospahmide can be tried for a period of 3 months. Cyclophosphamide may require lot of monitoring in form of complete blood count weekly as it can cause the counts to drop and also testicular toxicity. Your nephrologist has rightly advised you and you need to maintain your child under strict monitoring and treatment as nephrotic syndrome has a course of relapses and remissions. The goal is to prevent protein loss in the urine and maintain normal functions of the kidney. Back to All Questions

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