Serum Calcium, Phosphate and Alkaline Phosphatase Levels in Protein Energy Malnutrition

Abstract

Summary: Serum calcium, inorganic phosphate, alkaline phosphatase, total protein and albumin were determined in 100 children with different types of protein-energy malnutrition (PEM). Twenty apparently healthy children selected from the general clinic population served as controls. Hypocalcemia and hypophosphatemia were common in PEM, especially in kwashiorkor and nutritional oedema. Serum alkaline phosphatase was also low, even in those children with clinical and/or radiological rickets. It is concluded that "latent rickets" is common in all forms of PEM and that overt rickets occasionally occurs. There is however, no compelling need for routine calcium or Vitamin D therapy in these patients since the abnormal biochemical parameters return to normal with successful dietary management.