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July 1987, Vol 141, No. 7 >
Article | July 1987

Calcium, Phosphorus, Magnesium, and Calcitonin Concentrations in the Serum and Cerebrospinal Fluid of Children FREE

Pankaja S. Venkataraman, MBBS; Melissa R. Kirk; Reginald C. Tsang, MBBS; I-Wen Chen, PhD
[+] Author Affiliations

Accepted for publication Oct 28,1986.

Read in part before the 24th Annual Meeting of the American College of Nutrition, Cincinnati, Sept 20, 1983.

Reprint requests to Department of Pediatrics, University of Cincinnati College of Medicine, 231 Bethesda Ave, Cincinnati, OH 45267-0541 (Dr Tsang).


Am J Dis Child. 1987;141(7):751-753. doi:10.1001/archpedi.1987.04460070053022.
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Comments

• Mineral metabolism in the cerebrospinal fluid (CSF) of children is poorly understood. Recent reports have suggested a neuroregulatory role for calcitonin. We examined the hypotheses that in children (1) CSF levels of calcium and phosphorus might be low, (2) CSF levels of magnesium might be higher than serum levels of magnesium, and (3) immunoreactive calcitonin might be present in the CSF. We examined serum and CSF samples of 45 children, aged 8 days to 16 years, undergoing spinal taps for suspected meningitis or as part of leukemia therapy. Both serum and CSF levels of calcium correlated with those of magnesium. There was no correlation for CSF levels vs serum levels of calcium, magnesium, or phosphorus. The CSF levels of calcium and phosphorus were lower than the serum levels of these elements, but the CSF levels of magnesium were higher than the serum levels of magnesium. Calcitonin was detected in the CSF of 8% of samples assayed (range, 14 to 175 ng/L [14 to 175 pg/mL]). Two of these five samples had bacteriologically proven meningitis, and two samples were from patients less than 2 months of age. The CSF levels of calcitonin did not correlate with the serum levels of calcitonin. Thus, in children (1) CSF levels of calcium and phosphorus are low, (2) CSF levels of magnesium are higher than the serum levels, and (3) the level of immunoreactive calcitonin is usually not present in the CSF but possibly is elevated in meningitis and early infancy.

(AJDC 1987;141:751-753)

REFERENCES

1 +
Goldstein DA, Romoff M, Bogin E, et al:  Relationship between the concentrations of calcium and phosphorus in blood and cerebrospinal fluid . J Clin Endocrinol Metab 1979;;49:58-62.
2 +
Merritt H, Bauer W:  The equilibrium between cerebrospinal fluid and blood plasma: The calcium content of serum, cerebrospinal fluid and aqueous humor at different levels of parathyroid activity . J Biol Chem 1931;;90:233-246.
3 +
Dayson H:  Chemical composition and secretory nature of the fluids: Measurement of the distribution ratios , in Davson H (ed): Physiology of the Cerebrospinal Fluid . Boston, Little Brown & Co Inc, 1967;, pp 33-48.
4 +
Merritt HH, Bauer W:  The equilibrium between cerebrospinal fluid and blood plasma: The distribution of calcium and phosphorus between cerebrospinal fluid blood serum . J Biol Chem 1931;;90:215-232.
5 +
Balabanov S, Tollner U, Richter H-P, et al:  Immunoreactive parathyroid hormone, calcium and magnesium in human cerebrospinal fluid . Acta Endocrinol 1984;;106:227-233.
6 +
Chaparwal BG, Pohowalla JN:  Magnesium levels in serum and in CSF in common neurological disorders in infants and children . Indian Pediatr 1966;;3:139-144.
7 +
Pavlinac DM, Lenhard LW, Parthemore JG, et al:  Immunoreactive calcitonin in human cerebrospinal fluid . J Clin Endocrinol Metab 1980;; 50:717-720.
8 +
Morimoto S, Nishimura J, Miyanchi A, et al:  Calcitonin in plasma and cerebrospinal fluid from normal subjects and patients with medullary thyroid carcinoma: Possible restriction of calcitonin by blood brain barrier . J Clin Endocrinol Metab 1982;;55:594-596.
9 +
Freed NJ, Perlow MJ, Wyatt RJ:  Calcitonin: Inhibitory effect on eating in rats . Science 1979;; 206:850-852.
10 +
Morley JE, Levine AS, Silvis SE:  Intraventricular calcitonin inhibits gastric acid secretion . Science 1981;;214:671-673.
11 +
Bates RLF, Buckley GA, Eglen RM, et al:  Comparison of analgesic effects of subcutaneous and intracerebroventricular injection of calcitonin on acetic acid–induced abdominal constrictions in the mouse . Br J Pharmacol 1981;;72:575.
12 +
Sunderman FW Jr, Carroll JE:  Measurement of serum calcium and magnesium by atomic absorption spectrometry . Am J Clin Pathol 1963;; 43:302-310.
13 +
Natelson S: Techniques in Clinical Chemistry , ed 3. Springfield, Ill, Charles C Thomas Publishers, 1971;, pp 576-579.
14 +
Heath H III, Sizemore GW:  Plasma calcitonin in normal man: Differences between men and women . J Clin Invest 1977;;60:1135-1140.
15 +
Tashjian AJ Jr:  Immunoassay of thyrocalcitonin . Endocrinology 1969;;84:140-148.
16 +
Carter P:  Preparation of liquid-free human serum for radioimmunoassay by absorption on activated charcoal . Clin Chem 1978;;24:362-364.
17 +
Statistical Analysis System . Cary, NC, SAS Institute Inc, 1979;.
18 +
Specker BL, Lichtenstein P, Mimouni F, et al:  Calcium-regulating hormones and minerals from birth to 18 months: A cross-sectional study . Pediatrics 1986;;77:891-896.
19 +
Cooper CW, Peng TC, Obie JF, et al:  Calcitoninlike immunoreactivity in rat and human pituitary glands: Histochemical, in vitro and in vivo studies . Endocrinology 1980;;107:98-106.
20 +
Rizzo AJ, Goltzman D:  Calcitonin receptors in the central nervous system of the rat . Endocrinology 1981;;108:1672.
21 +
Samaan NA, Leavens ME:  Calcitoninlike immunoreactivity in the pituitary vascular bed of man . J Clin Endocrinol Metab 1981;;53:985-989.
22 +
Barling RWA, Selkon JB:  The penetration of antibiotics into cerebrospinal fluid and brain tissue . J Antimicrob Chemother 1978;;4:203-227.
23 +
Bradbury MWB, Crowder J, Desai S, et al:  Electrolytes and water in the brain and cerebrospinal fluid of the fetal sheep and guinea pig . J Physiol 1972;;227:591-610.
24 +
Amtorp O, Sorensen SC:  The ontogenetic development of concentration differences for protein and ions between plasma and cerebrospinal fluid in rabbits and rats . J Physiol 1974;;243:387-400.
25 +
Ferguson RK, Woodbury DM:  Penetration of 14C-inulin and 14C-sucrose into brain, cerebrospinal fluid and skeletal muscle of developing rats . Exp Brain Res 1969;;7:181-194.
26 +
Amara SG, Evans RM, Rosenfeld MG:  Calcitonin/calcitonin gene–related peptide transcription unit: Tissue-specific expression involves selective use of alternative polyadenylation sites . Mol Cell Biol 1984;;4:2141-2160.
27 +
Fisher LA, Kikkawa DO, Rivier Je, et al:  Stimulation of nonadrenergic sympathetic outflow by calcitonin gene–related peptide . Nature 1983;;305:534-536.
28 +
Lenz HJ, Rivier JE, Brown MR:  Biologic actions of human and rat calcitonin and calcitonin gene–related peptide . Regul Pept 1985;;12:81-89.

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References

1 +
Goldstein DA, Romoff M, Bogin E, et al:  Relationship between the concentrations of calcium and phosphorus in blood and cerebrospinal fluid . J Clin Endocrinol Metab 1979;;49:58-62.
2 +
Merritt H, Bauer W:  The equilibrium between cerebrospinal fluid and blood plasma: The calcium content of serum, cerebrospinal fluid and aqueous humor at different levels of parathyroid activity . J Biol Chem 1931;;90:233-246.
3 +
Dayson H:  Chemical composition and secretory nature of the fluids: Measurement of the distribution ratios , in Davson H (ed): Physiology of the Cerebrospinal Fluid . Boston, Little Brown & Co Inc, 1967;, pp 33-48.
4 +
Merritt HH, Bauer W:  The equilibrium between cerebrospinal fluid and blood plasma: The distribution of calcium and phosphorus between cerebrospinal fluid blood serum . J Biol Chem 1931;;90:215-232.
5 +
Balabanov S, Tollner U, Richter H-P, et al:  Immunoreactive parathyroid hormone, calcium and magnesium in human cerebrospinal fluid . Acta Endocrinol 1984;;106:227-233.
6 +
Chaparwal BG, Pohowalla JN:  Magnesium levels in serum and in CSF in common neurological disorders in infants and children . Indian Pediatr 1966;;3:139-144.
7 +
Pavlinac DM, Lenhard LW, Parthemore JG, et al:  Immunoreactive calcitonin in human cerebrospinal fluid . J Clin Endocrinol Metab 1980;; 50:717-720.
8 +
Morimoto S, Nishimura J, Miyanchi A, et al:  Calcitonin in plasma and cerebrospinal fluid from normal subjects and patients with medullary thyroid carcinoma: Possible restriction of calcitonin by blood brain barrier . J Clin Endocrinol Metab 1982;;55:594-596.
9 +
Freed NJ, Perlow MJ, Wyatt RJ:  Calcitonin: Inhibitory effect on eating in rats . Science 1979;; 206:850-852.
10 +
Morley JE, Levine AS, Silvis SE:  Intraventricular calcitonin inhibits gastric acid secretion . Science 1981;;214:671-673.
11 +
Bates RLF, Buckley GA, Eglen RM, et al:  Comparison of analgesic effects of subcutaneous and intracerebroventricular injection of calcitonin on acetic acid–induced abdominal constrictions in the mouse . Br J Pharmacol 1981;;72:575.
12 +
Sunderman FW Jr, Carroll JE:  Measurement of serum calcium and magnesium by atomic absorption spectrometry . Am J Clin Pathol 1963;; 43:302-310.
13 +
Natelson S: Techniques in Clinical Chemistry , ed 3. Springfield, Ill, Charles C Thomas Publishers, 1971;, pp 576-579.
14 +
Heath H III, Sizemore GW:  Plasma calcitonin in normal man: Differences between men and women . J Clin Invest 1977;;60:1135-1140.
15 +
Tashjian AJ Jr:  Immunoassay of thyrocalcitonin . Endocrinology 1969;;84:140-148.
16 +
Carter P:  Preparation of liquid-free human serum for radioimmunoassay by absorption on activated charcoal . Clin Chem 1978;;24:362-364.
17 +
Statistical Analysis System . Cary, NC, SAS Institute Inc, 1979;.
18 +
Specker BL, Lichtenstein P, Mimouni F, et al:  Calcium-regulating hormones and minerals from birth to 18 months: A cross-sectional study . Pediatrics 1986;;77:891-896.
19 +
Cooper CW, Peng TC, Obie JF, et al:  Calcitoninlike immunoreactivity in rat and human pituitary glands: Histochemical, in vitro and in vivo studies . Endocrinology 1980;;107:98-106.
20 +
Rizzo AJ, Goltzman D:  Calcitonin receptors in the central nervous system of the rat . Endocrinology 1981;;108:1672.
21 +
Samaan NA, Leavens ME:  Calcitoninlike immunoreactivity in the pituitary vascular bed of man . J Clin Endocrinol Metab 1981;;53:985-989.
22 +
Barling RWA, Selkon JB:  The penetration of antibiotics into cerebrospinal fluid and brain tissue . J Antimicrob Chemother 1978;;4:203-227.
23 +
Bradbury MWB, Crowder J, Desai S, et al:  Electrolytes and water in the brain and cerebrospinal fluid of the fetal sheep and guinea pig . J Physiol 1972;;227:591-610.
24 +
Amtorp O, Sorensen SC:  The ontogenetic development of concentration differences for protein and ions between plasma and cerebrospinal fluid in rabbits and rats . J Physiol 1974;;243:387-400.
25 +
Ferguson RK, Woodbury DM:  Penetration of 14C-inulin and 14C-sucrose into brain, cerebrospinal fluid and skeletal muscle of developing rats . Exp Brain Res 1969;;7:181-194.
26 +
Amara SG, Evans RM, Rosenfeld MG:  Calcitonin/calcitonin gene–related peptide transcription unit: Tissue-specific expression involves selective use of alternative polyadenylation sites . Mol Cell Biol 1984;;4:2141-2160.
27 +
Fisher LA, Kikkawa DO, Rivier Je, et al:  Stimulation of nonadrenergic sympathetic outflow by calcitonin gene–related peptide . Nature 1983;;305:534-536.
28 +
Lenz HJ, Rivier JE, Brown MR:  Biologic actions of human and rat calcitonin and calcitonin gene–related peptide . Regul Pept 1985;;12:81-89.

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