Hypovitaminosis D and severe hypocalcaemia: the rebirth of an old disease

Pedrosa, Cristina; Ferraria, Nélia; Limbert, Catarina; Lopes, Lurdes

doi:10.1136/bcr-2012-007406

Cited by 10 publications

(6 citation statements)

References 26 publications

(22 reference statements)

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“…In all age groups, a severe vitamin D deficiency is related to bone pain of various intensity and localization (predominantly in the lower limbs and feet) as well as increased susceptibility to bone fractures. Advanced stages of nutritional rickets and osteomalacia may be even the life-threatening conditions, characterized not only by bone deformations, but also by hypocalcemic seizures ( 29 , 30 ), tetany ( 31 , 32 ), severe bone pain and significant muscle weakness ( 33 , 34 ), hypocalcemic cardiomiopathy, even resulting in circulatory failure ( 35 – 38 ), and by disorders of psychomotor and physical development ( 39 ), including short stature ( 4 , 40 ).…”

Section: Evidence Base For Updated Polish Recommendationsmentioning

confidence: 99%

Vitamin D Supplementation Guidelines for General Population and Groups at Risk of Vitamin D Deficiency in Poland—Recommendations of the Polish Society of Pediatric Endocrinology and Diabetes and the Expert Panel With Participation of National Specialist Consultants and Representatives of Scientific Societies—2018 Update

et al. 2018

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IntroductionVitamin D deficiency is an important public health problem worldwide. Vitamin D deficiency confers a significant risk for both skeletal and non-skeletal disorders and a number of lifelong negative health outcomes. The objectives of this evidence-based guidelines document are to provide health care professionals in Poland, an updated recommendation for the prevention, diagnosis and treatment of vitamin D deficiency.MethodsA systematic literature search examining the prevention and treatment strategies for vitamin D deficiency was conducted. Updated recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation system describing the strength of the recommendation and the quality of supporting evidence. Twenty-seven contributors representing different areas of expertise and medical specialties, including pediatricians, geriatricians, endocrinologists, epidemiologists, nephrologists, gynecologists and obstetricians evaluated the available published evidence related to vitamin D, formulated the goals of this document and developed a common consolidated position. The consensus group, representing six national specialist consultants and eight Polish and international scientific organizations/societies, participated in the process of grading evidence and drawing up the general and specific recommendations.ResultsThe updated recommendations define the diagnostic criteria for the evaluation of vitamin D status and describe the prevention and treatment strategies of vitamin D deficiency in the general population and in groups at increased risk of the deficiency. Age- and weight-specific recommendations for prevention, supplementation and treatment of vitamin D deficiency are presented, and detailed practice guidance is discussed regarding the management in primary and specialized health care.ConclusionVitamin D deficiency remains still highly prevalent in Poland, in all age groups. Currently, there is a great necessity to implement a regular supplementation with recommended doses and to develop an effective strategy to alleviate vitamin D deficiency in the population. These updated recommendations are addressed to health professionals and the authorities pursuing comprehensive health policies and should also be included in public health programs aimed at preventing a broad spectrum of chronic diseases.

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Section: Evidence Base For Updated Polish Recommendationsmentioning

confidence: 99%

Vitamin D Supplementation Guidelines for General Population and Groups at Risk of Vitamin D Deficiency in Poland—Recommendations of the Polish Society of Pediatric Endocrinology and Diabetes and the Expert Panel With Participation of National Specialist Consultants and Representatives of Scientific Societies—2018 Update

et al. 2018

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“…Yilmaz et al measured vitamin D, calcium, and PTH levels in 750 infants and found significantly lower vitamin D levels in preterm infants with hypocalcemia, but no significant difference in vitamin D levels between hypocalcemia and normocalcemia in term infants [ 5 ]. Nevertheless, there are multiple reports of hypocalcemic seizures in infancy attributed to VDD [ 6 , 7 ]. A population-based study in the United Kingdom estimated the incidence of hypocalcemic seizures due to VDD to be 3.49 per million children 0–15 years of age (95% CI: 2.81–4.26) and 44.36 per million in children 0-1 year of age (95% CI: 35.12–55.28) [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Bacteremia in a Newborn with Hypocalcemic Seizures and Vitamin D Deficiency

Moore

Lorenz

Fredette

et al. 2021

Case Reports in Endocrinology

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Infants with neonatal hypocalcemia often present with seizures, and neonatal hypocalcemia can be due to parathyroid (PTH) insufficiency or resistance. Causes of hypocalcemia with PTH elevation include increased phosphate load, vitamin D deficiency (VDD) or defects in metabolism, renal dysfunction, hypomagnesemia, genetic mutations resulting in end-organ resistance to PTH, or critical illness. Hypocalcemia has also been shown to be associated with Gram-negative bacteremia and sepsis in adults. We present the case of a full-term, formula-fed newborn presenting with late-onset hypocalcemic seizures and VDD in the setting of Klebsiella pneumoniae bacteremia. This case highlights that newborns presenting with hypocalcemic seizures should undergo a workup for sepsis.

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“…This condition could be secondary to nutritional deficiency and could explain the hypocalcaemic seizures this child presented in the first year of life, and the delayed achievement of motor milestones due to decreased muscle tone and recurrent infection 7 8. Despite having several risk factors for nutritional vitamin D deficiency (late preterm, dark skin, low sun exposure due to multiple hospital admissions6), normal–high serum 1.25(OH) 2 D 3 suggests a genetic aetiology: vitamin D-dependent rickets type I or II, both autosomal recessive disorders.…”

Section: Discussionmentioning

confidence: 99%