PMC5124465_01
Trends in serum ionized calcium and phosphorus levels in a 10-year-old girl with hypoparathyroidism over the course of hospitalization. Minimum and maximum daily levels of iCa (circles and solid and dashed lines, resp.) and P (squares and dashed and solid lines, resp.) are shown. Black arrows indicate individual calcium gluconate boluses (2.5 g each). Open arrows point to once daily subcutaneous administration of teriparatide. Oral supplementation consisted of calcium carbonate except for Days 5-12 when calcium glubionate was given. ECa, elemental calcium.
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fig1
She required multiple calcium gluconate boluses.  Figure 1 shows trends in iCa and P levels along with calcium and calcitriol doses.
PMC5124465_02
Trends in serum ionized calcium and phosphorus levels in a 12-year-old girl with hypoparathyroidism over the course of hospitalization. Minimum and maximum daily levels of iCa (circles and solid and dashed lines, resp.) and P (squares and dashed and solid lines, resp.) are shown. Black arrows indicate individual calcium gluconate boluses (1 g each). Open arrows point to days of subcutaneous administration of teriparatide with the numbers above the arrows indicating once daily (1) or twice daily (2) injections. Oral supplementation consisted of calcium carbonate except for Days 2-3 when calcium citrate was also given. ECa, elemental calcium.
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fig2
Laboratory evaluation revealed severe hypocalcemia (iCa 2.8 mg/dL, Figure 2) and hyperphosphatemia (8.6 mg/dL).