Hypocalcaemic cardiac failure post BMT secondary to unrecognized vitamin D deficiency

Lee, P; Milliken, Samuel

doi:10.1038/bmt.2008.178

Cited by 8 publications

(5 citation statements)

References 9 publications

(6 reference statements)

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“…Contrary to the view that vitamin D deficiency is a mild chronic condition, recent reports associating vitamin D deficiency with severe hypocalcaemia in intensive care [1,2] highlight how vitamin D deficiency may contribute to acute complications. In a recent observational study, the prevalence of vitamin D insufficiency (serum 25-hydroxyvitamin D (25-OH D) between 30 to 60 nmol/L) and deficiency (serum 25-OH D \30 nmol/L) was estimated to be as high as 50% in critically ill patients, with undetectable vitamin D levels in 17% of patients [3].…”

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confidence: 82%

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Vitamin D deficiency in the intensive care unit: an invisible accomplice to morbidity and mortality?

2009

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The association between vitamin D deficiency and chronic illness is well-known. Vitamin D deficiency has been associated with increased mortality in the general population. Despite this knowledge, vitamin D insufficiency is seldom considered and rarely replaced adequately, if at all, in critically ill patients in intensive care. We present a hypothetic model demonstrating how vitamin D deficiency may be an unrecognized contributor to adverse outcome in intensive care patients.

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confidence: 82%

“…Hypocalcaemia therefore does not occur unless PTH action is insufficient, as in hypoparathyroidism or PTH resistance (e.g. hypomagnesaemia, renal failure resulting in inadequate renal 1a-hydroxylation), or if vitamin D is severely deficient not allowing adequate formation of 1,25-(OH) 2 D despite maximal PTH stimulation [1,2].…”

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confidence: 99%

Vitamin D deficiency in the intensive care unit: an invisible accomplice to morbidity and mortality?

2009

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“…Various forms of calcium and calcitriol supplementation were unable to demonstrate sustained effects and in some cases resulted in hypercalcemia and increased mortality [2]. Several case reports have suggested vitamin D deficiency as a cause of hypocalcemia with adverse outcome, which can be corrected effectively and safely by vitamin D supplementation [4,5]. …”

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confidence: 99%

Short-term effects of high-dose oral vitamin D3 in critically ill vitamin D deficient patients: a randomized, double-blind, placebo-controlled pilot study

et al. 2011

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IntroductionVitamin D deficiency is encountered frequently in critically ill patients and might be harmful. Current nutrition guidelines recommend very low vitamin D doses. The objective of this trial was to evaluate the safety and efficacy of a single oral high-dose vitamin D3 supplementation in an intensive care setting over a one-week observation period.MethodsThis was a randomized, double-blind, placebo-controlled pilot study in a medical ICU at a tertiary care university center in Graz, Austria. Twenty-five patients (mean age 62 ± 16yrs) with vitamin D deficiency [25-hydroxyvitamin D (25(OH)D) ≤20 ng/ml] and an expected stay in the ICU >48 hours were included and randomly received either 540,000 IU (corresponding to 13.5 mg) of cholecalciferol (VITD) dissolved in 45 ml herbal oil or matched placebo (PBO) orally or via feeding tube.ResultsThe mean serum 25(OH)D increase in the intervention group was 25 ng/ml (range 1-47 ng/ml). The highest 25(OH)D level reached was 64 ng/ml, while two patients showed a small (7 ng/ml) or no response (1 ng/ml). Hypercalcemia or hypercalciuria did not occur in any patient. From day 0 to day 7, total serum calcium levels increased by 0.10 (PBO) and 0.15 mmol/L (VITD; P < 0.05 for both), while ionized calcium levels increased by 0.11 (PBO) and 0.05 mmol/L (VITD; P < 0.05 for both). Parathyroid hormone levels decreased by 19 and 28 pg/ml (PBO and VITD, ns) over the seven days, while 1,25(OH)D showed a transient significant increase in the VITD group only.ConclusionsThis pilot study shows that a single oral ultra-high dose of cholecalciferol corrects vitamin D deficiency within 2 days in most patients without causing adverse effects like hypercalcemia or hypercalciuria. Further research is needed to confirm our results and establish whether vitamin D supplementation can affect the clinical outcome of vitamin D deficient critically ill patients.EudraCT Number2009-012080-34German Clinical Trials Register (DRKS)DRKS00000750

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“…Since the mid-1990s, several laboratories in various parts of the world have consistently reported aromatase mRNA and enzyme activity in endometriotic tissues and cells. [1][2][3][4] My colleagues and I have reported the presence of aromatase in endometriosis, and we have described the signaling pathway responsible for coordinated induction of aromatase and other steroidogenic genes required for the production of estradiol from cholesterol in endometriotic tissue. 1 The letter by Colette and Donnez contradicts their recently published article in which they reported that aromatase mRNA was detected in all but 2 of the approximately 60 samples of ovarian, peritoneal, and deep endometriotic tissues they studied.…”

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Vitamin D Deficiency in Critically Ill Patients

Lee¹,

Eisman²,

Center³

2009

N Engl J Med

233

119

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Hypocalcaemic cardiac failure post BMT secondary to unrecognized vitamin D deficiency

Cited by 8 publications

References 9 publications

Vitamin D deficiency in the intensive care unit: an invisible accomplice to morbidity and mortality?

Vitamin D deficiency in the intensive care unit: an invisible accomplice to morbidity and mortality?

Short-term effects of high-dose oral vitamin D3 in critically ill vitamin D deficient patients: a randomized, double-blind, placebo-controlled pilot study

Vitamin D Deficiency in Critically Ill Patients

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