Hypocalcemia and Stridor: An Unusual Presentation of Vitamin D-Deficient Rickets

The differential diagnosis of stridor in the pediatric population is broad and should include hypocalcemia with resultant laryngospasm. We present the case of a breast-fed infant who presented to the pediatric emergency department with profound stridor during the winter months because of hypocalcemia of undiagnosed rickets. The patient responded to intravenous calcium chloride with rapid resolution of symptoms. Emergency physicians should consider obtaining ionized calcium levels in pediatric patients with stridor, especially when standard therapies for more common causes of stridor are ineffective.