Clinical, biochemical, and radiological manifestations of vitamin D deficiency in newborns presented with hypocalcemia
Introduction: The Clinical and radiological manifestations of newborns with severe VDD have not been studied well. Materials and Methods: We studied the clinical, biochemical, and radiological manifestations of 10 full-term (FT) newborns (6: M, 4: F) infant presented to with symptomatic hypocalcemia...
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Wolters Kluwer Medknow Publications
2013-01-01
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| Series: | Indian Journal of Endocrinology and Metabolism |
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| Online Access: | http://www.ijem.in/article.asp?issn=2230-8210;year=2013;volume=17;issue=4;spage=697;epage=703;aulast=Soliman |
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| author | Ashraf Soliman Husam Salama Sufwan Alomar Emad Shatla Khaled Ellithy Elsaid Bedair |
| author_facet | Ashraf Soliman Husam Salama Sufwan Alomar Emad Shatla Khaled Ellithy Elsaid Bedair |
| author_sort | Ashraf Soliman |
| collection | DOAJ |
| description | Introduction: The Clinical and radiological manifestations of newborns with severe VDD have not been studied well. Materials and Methods: We studied the clinical, biochemical, and radiological manifestations of 10 full-term (FT) newborns (6: M, 4: F) infant presented to with symptomatic hypocalcemia (seizure) secondary to vitamin D deficiency (VDD) during the first 10 days of life are described. All were exclusively breastfed since birth. All their mothers have low 25 hydroxy vitamin D (25OHD) level <10 ng/mL and were not taking vitamin supplements during pregnancy. Results: FT newborns with hypocalcemia secondary to VDD presented with generalized convulsions (10/10) and craniotabes (8/10), but none had rachitic chest rosaries or joint broadening. Cranial ultrasonographic evaluation was normal. Serum 25OHD concentrations were low in these newborns (13.2 ± 3.8 ng/mL) and their mothers (8.1 ± 1.5 ng/mL). A total of 60% of them had increased parathormone (PTH) concentrations (>60 ng/mL) and 60% had decreased magnesium (Mg) concentrations (<0.7 mmol/L). Their alkaline phosphatase (ALP) concentrations were significantly higher than normal newborns. All other laboratory results (liver function tests, urea and electrolytes, C reactive protein, lumbar puncture, blood culture, and lactate) were normal. In all patients, seizures ceased within 2 days of starting treatment with alphacalcidol and calcium. Radiological manifestations included metaphyseal band of relative lucency (osteopenia), just under the line of provisional calcification, within distal radius (7/10), femur (4/10), and tibia (3/10), mild cupping and haziness of distal radius (2/10). Discussion: Newborns with VDD had significantly lower serum calcium, ALP and PTH and higher phosphate concentrations, compared to older infants with VDD rickets. In newborns with VDD, serum calcium levels were correlated significantly with 25OHD (r = 0.597, P < 0.001), Mg concentrations (r = 0.436, P < 0.001) and negatively with ALP concentrations (r = −0.451, P < 0.001). Serum PTH concentrations were correlated significantly with serum Mg (r = 0.78, P < 0.0001) but not with serum calcium (r = −0.103, P = 0.3) or 25OHD (r = −0.03, P = 0.7) concentrations. Conclusion: The clinical, biochemical, and radiological manifestations of VDD in newborns indicate that they are less adapted to VDD compared to older infants. VD supplementation for mothers and newborns should be considered to avoid short-term complications of VDD in the neonatal period and on the growing infants especially in countries with high prevalence of VDD. |
| first_indexed | 2024-12-14T13:04:58Z |
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| issn | 2230-8210 2230-9500 |
| language | English |
| last_indexed | 2024-12-14T13:04:58Z |
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| publisher | Wolters Kluwer Medknow Publications |
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| series | Indian Journal of Endocrinology and Metabolism |
| spelling | doaj.art-afd3c764084a4d6ea286e6f88f18eb172022-12-21T23:00:21ZengWolters Kluwer Medknow PublicationsIndian Journal of Endocrinology and Metabolism2230-82102230-95002013-01-0117469770310.4103/2230-8210.113764Clinical, biochemical, and radiological manifestations of vitamin D deficiency in newborns presented with hypocalcemiaAshraf SolimanHusam SalamaSufwan AlomarEmad ShatlaKhaled EllithyElsaid BedairIntroduction: The Clinical and radiological manifestations of newborns with severe VDD have not been studied well. Materials and Methods: We studied the clinical, biochemical, and radiological manifestations of 10 full-term (FT) newborns (6: M, 4: F) infant presented to with symptomatic hypocalcemia (seizure) secondary to vitamin D deficiency (VDD) during the first 10 days of life are described. All were exclusively breastfed since birth. All their mothers have low 25 hydroxy vitamin D (25OHD) level <10 ng/mL and were not taking vitamin supplements during pregnancy. Results: FT newborns with hypocalcemia secondary to VDD presented with generalized convulsions (10/10) and craniotabes (8/10), but none had rachitic chest rosaries or joint broadening. Cranial ultrasonographic evaluation was normal. Serum 25OHD concentrations were low in these newborns (13.2 ± 3.8 ng/mL) and their mothers (8.1 ± 1.5 ng/mL). A total of 60% of them had increased parathormone (PTH) concentrations (>60 ng/mL) and 60% had decreased magnesium (Mg) concentrations (<0.7 mmol/L). Their alkaline phosphatase (ALP) concentrations were significantly higher than normal newborns. All other laboratory results (liver function tests, urea and electrolytes, C reactive protein, lumbar puncture, blood culture, and lactate) were normal. In all patients, seizures ceased within 2 days of starting treatment with alphacalcidol and calcium. Radiological manifestations included metaphyseal band of relative lucency (osteopenia), just under the line of provisional calcification, within distal radius (7/10), femur (4/10), and tibia (3/10), mild cupping and haziness of distal radius (2/10). Discussion: Newborns with VDD had significantly lower serum calcium, ALP and PTH and higher phosphate concentrations, compared to older infants with VDD rickets. In newborns with VDD, serum calcium levels were correlated significantly with 25OHD (r = 0.597, P < 0.001), Mg concentrations (r = 0.436, P < 0.001) and negatively with ALP concentrations (r = −0.451, P < 0.001). Serum PTH concentrations were correlated significantly with serum Mg (r = 0.78, P < 0.0001) but not with serum calcium (r = −0.103, P = 0.3) or 25OHD (r = −0.03, P = 0.7) concentrations. Conclusion: The clinical, biochemical, and radiological manifestations of VDD in newborns indicate that they are less adapted to VDD compared to older infants. VD supplementation for mothers and newborns should be considered to avoid short-term complications of VDD in the neonatal period and on the growing infants especially in countries with high prevalence of VDD.http://www.ijem.in/article.asp?issn=2230-8210;year=2013;volume=17;issue=4;spage=697;epage=703;aulast=SolimanAdaptationcalciuminfantsmaternalnewborns25OH vitamin Dparathormonephosphateradiologyricketsvitamin D deficiency |
| spellingShingle | Ashraf Soliman Husam Salama Sufwan Alomar Emad Shatla Khaled Ellithy Elsaid Bedair Clinical, biochemical, and radiological manifestations of vitamin D deficiency in newborns presented with hypocalcemia Indian Journal of Endocrinology and Metabolism Adaptation calcium infants maternal newborns 25OH vitamin D parathormone phosphate radiology rickets vitamin D deficiency |
| title | Clinical, biochemical, and radiological manifestations of vitamin D deficiency in newborns presented with hypocalcemia |
| title_full | Clinical, biochemical, and radiological manifestations of vitamin D deficiency in newborns presented with hypocalcemia |
| title_fullStr | Clinical, biochemical, and radiological manifestations of vitamin D deficiency in newborns presented with hypocalcemia |
| title_full_unstemmed | Clinical, biochemical, and radiological manifestations of vitamin D deficiency in newborns presented with hypocalcemia |
| title_short | Clinical, biochemical, and radiological manifestations of vitamin D deficiency in newborns presented with hypocalcemia |
| title_sort | clinical biochemical and radiological manifestations of vitamin d deficiency in newborns presented with hypocalcemia |
| topic | Adaptation calcium infants maternal newborns 25OH vitamin D parathormone phosphate radiology rickets vitamin D deficiency |
| url | http://www.ijem.in/article.asp?issn=2230-8210;year=2013;volume=17;issue=4;spage=697;epage=703;aulast=Soliman |
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