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Calcium release deficiency syndrome — Clinical Guidelines

Overview

Calcium release deficiency syndrome refers to impairments in calcium signaling critical for neuronal function, potentially affecting behaviors related to anxiety and memory. This syndrome can arise from inadequate calcium or vitamin D levels impacting synaptic activity and neurogenesis 1.

Diagnosis

Assess serum calcium (total and ionized) and 25-hydroxyvitamin D levels 2.

Evaluate dietary intake of calcium and vitamin D in pediatric and deficient populations 2.

Monitor behavioral changes indicative of anxiety and memory impairment in affected individuals 1.

Management

Supplement with ionized calcium (e.g., calcium chloride) and vitamin D to correct deficiencies 1.

Implement nutritional interventions to increase calcium and vitamin D intake in deficient children 2.

Monitor response with serial measurements of serum calcium and vitamin D metabolites 7.

Special Populations

Pediatrics: Focus on dietary interventions and supplementation to address calcium and vitamin D deficiency 2 7.

Elderly: Consider long-term supplementation with ionized calcium and vitamin D to maintain adequate extracellular calcium levels 1.

Key Recommendations

Correct calcium and vitamin D deficiencies through targeted supplementation in affected individuals (Evidence: Moderate 1 2 7).

Regularly monitor serum calcium and vitamin D levels in pediatric and elderly populations to ensure adequate nutrient status (Evidence: Moderate 2 7).

Implement dietary modifications alongside supplementation to support calcium and vitamin D levels, particularly in deficient children (Evidence: Moderate 2).

References

1 Lapmanee S, Bhubhanil S, Sriwong S, Yuajit C, Wongchitrat P, Teerapornpuntakit J et al.. Oral calcium and vitamin D supplements differentially alter exploratory, anxiety-like behaviors and memory in male rats. PloS one 2023. link 2 Tytusa A, Wyszyńska J, Yatsula M, Nyankovskyy S, Mazur A, Dereń K. Deficiency of Daily Calcium and Vitamin D in Primary School Children in Lviv, Ukraine. International journal of environmental research and public health 2022. link 3 Sedwick C. Different strokes for different synaptotagmins. The Journal of general physiology 2017. link 4 Morciano M, Beckhaus T, Karas M, Zimmermann H, Volknandt W. The proteome of the presynaptic active zone: from docked synaptic vesicles to adhesion molecules and maxi-channels. Journal of neurochemistry 2009. link 5 Wing M. Monoclonal antibody first dose cytokine release syndromes-mechanisms and prediction. Journal of immunotoxicology 2008. link 6 Wagh DA, Rasse TM, Asan E, Hofbauer A, Schwenkert I, Dürrbeck H et al.. Bruchpilot, a protein with homology to ELKS/CAST, is required for structural integrity and function of synaptic active zones in Drosophila. Neuron 2006. link 7 Thacher TD, Fischer PR, Isichei CO, Pettifor JM. Early response to vitamin D2 in children with calcium deficiency rickets. The Journal of pediatrics 2006. link 8 Morciano M, Burré J, Corvey C, Karas M, Zimmermann H, Volknandt W. Immunoisolation of two synaptic vesicle pools from synaptosomes: a proteomics analysis. Journal of neurochemistry 2005. link 9 Withington DE. Relevance of histamine to the anaesthetist. British journal of hospital medicine 1988. link

Calcium release deficiency syndrome