Neonatal Hypocalcemic Convulsions Secondary to Vitamin D Deficiency

Abstract

Vitamin D deficiency is a major public health issue affecting large proportions of the population. Therefore, maternal vitamin D deficiency is not uncommon. Infants born to mothers who are deficient in vitamin D are at risk of developing vitamin D deficiency and hypocalcaemia. We reported here a case of neonatal hypocalcaemic seizures secondary to vitamin D deficiency. A 25-day old, full term male infant presented two episodes of generalized seizures. Laboratory investigations in blood, revealed low calcium level at 5.5 mg/dl, elevated phosphatemia level at 9.6 mg/dl and high parathormone (PTH) level at 133.4 pg/ml. Unfortunately 25 hydroxy vitamin D assay was not available in the infant but it was low in the mother at 12.9 ng/ml. The infant was commenced on vitamin D and calcium supplements during some weeks which allowed normalization of calcium levels. After several months of treatment cessation, the infant was doing well, and his development was according to his chronological age. His calcium, phosphatemia and PTH levels were within normal ranges without any treatment. Hypocalcemia in this infant was presumably due to vitamin D deficiency as other causes were unlikely. Neonatal hypocalcaemic seizures are a rare presentation of vitamin D deficiency. This case could have been preventable had the mother been given vitamin D supplementation during pregnancy and early lactation.