{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:05:57Z","timestamp":1756339557274,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,8,11]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>Hypocalcaemia is a common metabolic abnormality in neonates, with distinct causes based on the timing of onset. Early-onset hypocalcaemia (within 72 hours of life) is typically related to transitional physiology, prematurity, perinatal asphyxia or maternal diabetes. In contrast, late-onset hypocalcaemia (after 72 hours) is less common and may result from high phosphate intake, cow\u2019s milk-based formulas, vitamin D deficiency or resistance, maternal vitamin D deficiency, hypoparathyroidism (eg, DiGeorge syndrome), magnesium deficiency or activating mutations in the calcium-sensing receptor. Clinical manifestations of late-onset hypocalcaemia can include seizures, tetany, irritability, arrhythmias or stridor. While most cases respond to oral calcium, vitamin D and magnesium supplementation, some are refractory to conventional therapy. We report a case of refractory neonatal hypocalcaemia that showed significant improvement with teriparatide, a recombinant parathyroid hormone analogue, highlighting the potential role of advanced pharmacological agents in difficult-to-treat cases of neonatal hypocalcaemia.<\/jats:p>","DOI":"10.1136\/bcr-2025-267344","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:15:35Z","timestamp":1756314935000},"page":"e267344","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Recalcitrant hypocalcaemia responding to teriparatide therapy: a clinical insight"],"prefix":"10.1136","volume":"18","author":[{"given":"Arohi","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Neonatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Preeti","family":"Dabadghao","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amruta","family":"Sathe","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3427-7441","authenticated-orcid":false,"given":"Anita","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8659-7658","authenticated-orcid":false,"given":"Kirti","family":"Naranje","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,8,27]]},"reference":[{"key":"2025082710152563000_18.8.e267344.1","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1007\/BF02723667","article-title":"Neonatal endocrinology","volume":"67","author":"Oden","year":"2000","journal-title":"Indian J Pediatr"},{"key":"2025082710152563000_18.8.e267344.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2003.10.002"},{"key":"2025082710152563000_18.8.e267344.3","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.5937\/hpimj2103090O","article-title":"Hypocalcemia of the newborn due to red blood cell transfusion: Case report","volume":"8","author":"Ota\u0161evi\u0107","year":"2021","journal-title":"Hosp Pharm Int Multi J"},{"key":"2025082710152563000_18.8.e267344.4","doi-asserted-by":"crossref","first-page":"15071","DOI":"10.1038\/nrdp.2015.71","article-title":"22q11.2 deletion syndrome","volume":"1","author":"McDonald-McGinn","year":"2015","journal-title":"Nat Rev Dis Primers"},{"key":"2025082710152563000_18.8.e267344.5","doi-asserted-by":"publisher","DOI":"10.1542\/peds.112.1.101"},{"key":"2025082710152563000_18.8.e267344.6","first-page":"2709","article-title":"Teriparatide: a review of its use in osteoporosis","volume":"68","author":"Blick","year":"2008","journal-title":"Drugs (Abingdon Engl)"},{"key":"2025082710152563000_18.8.e267344.7","unstructured":"Vall H , Patel P , Parmar M . Treasure Island (FL): StatPearls Publishing; Teriparatide, 2024. Available: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK559248\/ [Accessed 20 Feb 2024]."},{"key":"2025082710152563000_18.8.e267344.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc063043"},{"key":"2025082710152563000_18.8.e267344.9","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-2605"},{"key":"2025082710152563000_18.8.e267344.10","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1515\/JPEM.2008.21.4.385","article-title":"Autosomal dominant hypoparathyroidism with severe hypomagnesemia and hypocalcemia, successfully treated with recombinant PTH and continuous subcutaneous magnesium infusion","volume":"21","author":"Sanda","year":"2008","journal-title":"J Pediatr Endocrinol Metab"},{"key":"2025082710152563000_18.8.e267344.11","first-page":"80","article-title":"Teriparatide Therapy in a 4-Month-Old With Severe Hypoparathyroidism","volume":"27","author":"Bhatt","year":"2022","journal-title":"J Pediatr Pharmacol Ther"},{"key":"2025082710152563000_18.8.e267344.12","first-page":"11","article-title":"Three Siblings With Familial Isolated Hypoparathyroidism: A Diagnostic Journey From CASR to Novel GCM2 Variant","volume":"22","author":"Thambundit","year":"2024","journal-title":"JCEM Case Rep"},{"key":"2025082710152563000_18.8.e267344.13","doi-asserted-by":"crossref","DOI":"10.1210\/jcemcr\/luae059","article-title":"Recombinant PTH Infusion in a Child With Sanjad-Sakati Syndrome Refractory to Conventional Therapy","volume":"2","author":"Bali","year":"2024","journal-title":"JCEM Case Reports"},{"key":"2025082710152563000_18.8.e267344.14","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.jpeds.2011.09.022","article-title":"Recombinant parathyroid hormone therapy for severe neonatal hypoparathyroidism","volume":"160","author":"Cho","year":"2012","journal-title":"J Pediatr"},{"key":"2025082710152563000_18.8.e267344.15","doi-asserted-by":"publisher","DOI":"10.1530\/EC-17-0234"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-267344","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:15:38Z","timestamp":1756314938000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-267344"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":15,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8,27]]},"published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1136\/bcr-2025-267344"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-267344","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]}}}