{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T19:02:48Z","timestamp":1785265368211,"version":"3.55.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014188","name":"Ministry of Science and ICT, South Korea","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014188","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Severe hypocalcemia in children can precipitate life-threatening neurologic and cardiovascular events, including seizures and cardiac dysfunction. Etiologies range from nutritional deficiency to genetic syndromes, yet local epidemiologic and clinical data remain limited, particularly in Southeast Asia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed 246 children (newborns to 18 years) admitted with severe hypocalcemia at the Vietnam National Children\u2019s Hospital (2018 - 2024), the leading tertiary center in Northern Vietnam. Demographic, clinical, and comprehensive biochemical data were collected. Descriptive, bivariate, and multivariable logistic regression analyses identified independent predictors of major clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 246 children, infants and young children predominated (70.7%; median age 67 days). Seizures occurred in 79.2%, while vitamin D deficiency (67.1%) and hypoparathyroidism (28.0%) were the leading causes of severe hypocalcemia. The mean ionized calcium level was profoundly low (0.66 \u00b1 0.13 mmol\/L). Patients with vitamin D deficiency had markedly low 25(OH)D levels (mean 18.4 nmol\/L) and high PTH (mean 261.7 pg\/mL), consistent with secondary hyperparathyroidism. Conversely, those with hypoparathyroidism showed low PTH levels (22.2 pg\/mL) despite significant hypocalcemia. Children with DiGeorge syndrome had even lower PTH levels (6.3 pg\/mL) and preserved phosphate. In multivariate analyses, lower ionized calcium and lower 25-hydroxyvitamin D levels were independent predictors of seizures. Cardiac complications (cardiogenic shock and\/or acute heart failure) occurred in 5.7% and were associated with more severe hypocalcemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Severe pediatric hypocalcemia in Vietnam predominantly affects infants and young children and is largely attributable to preventable vitamin D deficiency. While vitamin D deficiency is globally recognized, this study provides novel region-specific insight into the high frequency of symptomatic presentations, including seizures and cardiac events, in a tropical setting with presumed adequate sunlight exposure. It also emphasizes distinct biochemical phenotypes that allow early etiological stratification. These findings reinforce the urgency of proactive vitamin D supplementation policies and biochemical screening protocols tailored for high-risk populations, particularly in resource-limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1701713","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T05:15:55Z","timestamp":1770009355000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Severe pediatric hypocalcemia in Vietnam: etiologic profile, clinical outcomes and risk factors in 246 cases"],"prefix":"10.3389","volume":"17","author":[{"given":"Thanh T.","family":"Nguyen","sequence":"first","affiliation":[{"name":"Center for Endocrinology, Metabolism, Genetic\/Genomics and Molecular Therapy, Vietnam National Children\u2019s Hospital","place":["Hanoi, Vietnam"]},{"name":"Department of Biomedical Science and Engineering, Gwangju Institute of Science and 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Thuy","family":"Hoa","sequence":"additional","affiliation":[{"name":"Center for Pediatrics, Bach Mai Hospital","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongryeol","family":"Ryu","sequence":"additional","affiliation":[{"name":"Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST)","place":["Gwangju, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vu Chi","family":"Dung","sequence":"additional","affiliation":[{"name":"Center for Endocrinology, Metabolism, Genetic\/Genomics and Molecular Therapy, Vietnam National Children\u2019s Hospital","place":["Hanoi, Vietnam"]},{"name":"Department of Pediatrics, University of Medicine and Pharmacy - Vietnam National University","place":["Hanoi, 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