%0 Journal Article
%T Parathyroid hormone changes in infants investigated for inflicted injury; an observational retrospective single centre cohort study
%J Child abuse and neglect
%D 2022
%A Lewis, L.
%A Borg, S.
%A Alison, L.
%A Hardisty, H.
%A Parry-Okeden, S.
%A Kerrin, D.
%A Chadha, L.
%A Roberts, K.
%A Shabani, K.
%A Offiah, A. C.
%A Bishop, N. J.
%V 131
%N 
%P e105775-e105775
%X BACKGROUND: Biochemical and haematological testing is recommended in the United Kingdom when inflicted injury is suspected. We examined the associations of test results with radiologically-confirmed fracture(s), and between test results, in a large retrospective observational cohort. <br><br>METHODS: Infants up to age two years presenting with suspected inflicted injury, without clinically or radiologically apparent bone disease, and where a skeletal survey was undertaken during the period 1st August 2013 to 31st December 2020, were included. Biochemical parameters: corrected calcium (cCa); phosphate (P); alkaline phosphatase (ALP); parathyroid hormone (PTH); 25-hydroxyvitamin D (25D); and haematological parameters: haemoglobin (Hb); mean corpuscular haemoglobin (MCH); mean corpuscular haemoglobin content (MCHC); mean corpuscular volume (MCV); platelet count were collated together with the results of the radiological assessments. <br><br>FINDINGS: Of 332 eligible infants (190 male), 142 (84 male) had fracture(s) and/or intracranial injury. Mean PTH in the non-fracture group (n measured 50/190) was 27.3 ng/l; in those with intracranial injury alone (n measured 9/23) was 39.4 ng/l; in those with fracture alone (n measured 62/84) was 45.0 ng/l; and in those with fracture and intracranial injury (n measured 20/35) 51.8 ng/l. F-test of multiple means = 0.0369. There was no difference in 25D between the groups. <br><br>INTERPRETATION: PTH was raised in infants who had fracture(s), intracranial injury or both. A single raised PTH may not necessarily be an indicator of prior disturbed skeletal health in these circumstances. The relevance of vitamin D status and interpretation of data from biochemical testing should be informed by the overall presentation in suspected inflicted injury cases. A single raised PTH may be a consequence of the child's injuries rather than prior disturbed bone health.<p /> <p>Language: en</p>
%G en
%I Elsevier Publishing
%@ 0145-2134
%U http://dx.doi.org/10.1016/j.chiabu.2022.105775