MON-260 Simple Febrile Seizure vs Hypocalcemic Seizure: Complicated Case of an 11-Month-Old

Background Hypocalcemia in young children can be an incidental finding, however, it may also present as spasms or seizures. Simple febrile seizures (SFS) are common benign convulsive events in children younger than 5 years. We present a case of an infant who presented with fever, seizures, and unresponsiveness and was found to have low calcium and Vitamin D levels. Case This 11-month-old African American female, born full term, was found unresponsive by parents at home after 2 days of URI symptoms and fever. She had upward eye rolling and stiffening of upper extremities and parents started CPR. On EMS arrival, the patient was responsive but weak. In the ER, she was febrile (103F), tachycardic, and alert. Physical examination was unremarkable except for nasal congestion. No frontal bossing, widening of wrist joint or long bone deformities were noted. On dietary history, patient was exclusively breastfed until 6 months of age. Upon presentation, she was on stage 1 food and expressed breast milk, but no other dairy products or vitamin supplements. Laboratory workup showed a normal CBC, serum calcium 4.8 mg/dl (9-11 mg/dl), ionized calcium 2.9 mg/dl (4.9-5.5mg/dl), phosphorus 3.6 mg/dl (4-6.5 mg/dl), 25 hydroxy-vitamin D