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A 2 mon. old child was investigated for repeated convulsions which were tonic,clonic in nature,responding to IV Calcium gluconate dramatically.Sr.Calcium 5.6mg%,Sr.Magnesium 1.4mg%,Alkaline Phosphatase760iu,Hb. 7.8Gm%,Sr.Phospherous 7.1mg%,CBC Not specific,Repeated Sr.Calcium levels were below 6 mg%.CT scan and Sr.Parathormone levels not done.Treated with Iv calcium gluconate IM Magsulf.What should be the probable diagnosis?PL suggest any additional investigations.
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Hypocalcemia and hypomagnesemia seem to be the cause. Rule out rickets as the alkaline phosphatase is high. Do an Xray of wrist. ALso find out if the child is on cows milk as that may cause the phosphorus to be slightly high. If one exclusive breast feeds, check the mother's calcium, phosphorus and alkaline phosphatase.
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