SUMMARY. The concentrations of serum calcium, parathyroid hormone (PTH), 25 Hydroxyvitamin D (250HD), and 1,25 Dihydroxyvitamin D (1,25(OH}zD) were determined in 99 Saudi patients with sickle cell disease and in 104 matching healthy controls. Serum calcium and 250HD were significantly lower in the patients, with 140/0 and 12% of them had serum calcium and 250HD concentrations, respectively, below the normal range. PTH was significantly higher in the patients, with 31% having values above the normal range. There was no significant difference between patients and controls in regard to 1,25(OH}zD. There was a significant inverse correlation of 250HD with PTH and a direct correlation of PTH with 1,25(OH}zD. Dietary intake of calcium and vitamin D was adequate in both patients and controls. The results indicate that sickle cell patients have hypocalcaemic tendency associated with supranormal PTH, and imply impaired intestinal absorption of calcium and vitamin D leading to a disturbed calcium metabolism which might contribute to the skeletal changes seen in sickle cell disease.Additional key phrases: diet; sunlight; 25 cholecalciferol; 1,25 cholecalciferol Vitamin D synthesized in the skin and absorbed in the intestine, undergoes metabolic transformations before exerting its effect on target tissues
In a 3-year period, eight cases of cerebrovascular accident were seen out of 400 patients with sickle cell disease residing at high and low altitudes of Asir Province of Saudi Arabia. They were all Saudi nationals and comprised five boys and three girls of ages ranging from 3.5 to 9 years. They had varied clinical presentations of their cerebrovascular accident. Cranial computed tomography in seven of them showed abnormality in the region of the middle cerebral circulation. Management and some suggested factors contributing to the occurrence of the cerebrovascular accident are discussed.
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