Department of Pediatrics, Zeynep Kamil Maternity and Childrens Diseases Research and Training State Hospital, Istanbul, Turkey.
Acta Paediatr. 2012 Mar;101(3):e122-5. doi: 10.1111/j.1651-2227.2011.02497.x. Epub 2011 Nov 4.
The aim of this report was to compare the efficacy of oral alendronate versus prednisolone treatment in addition to conventional measures in infants with vitamin D intoxication.
In six infants (aged 8.0 ± 2.1 months) with vitamin D intoxication, time to achieve normocalcemia with prednisolone treatment (Group I, n = 4) or alendronate treatment (Group II, n = 4, two infants started treatment from the baseline and two after unsuccessful prednisolone treatment) in addition to intravenous hydration and diuretic therapy were compared.
Baseline serum calcium levels ranged between 3.8 and 4.77 mmol/L. In the prednisolone group, although two patients reached normocalcemia on 7th and 12th days of treatment, other two patients did not despite 23 and 15 days of treatment and therefore switched to alendronate treatment. The mean duration of prednisolone treatment in these four patients was 14.2 ± 6.7 days (range 7-23). In the alendronate group, two patients who started treatment from the baseline achieved normocalcemia on the 5th day. Other two patients achieved normocalcemia 2 days after switching to alendronate. Thus, the mean time to reach normocalcemia after single oral alendronate administration was 3.5 ± 1.7 days (range 2-5) (p < 0.01 versus Group I).
Alendronate treatment achieves normocalcemia four times earlier than prednisolone treatment and shortens hospital stay in infants with vitamin D intoxication.
本报告旨在比较口服阿仑膦酸钠与泼尼松龙治疗联合常规措施在维生素 D 中毒婴儿中的疗效。
在 6 例维生素 D 中毒婴儿(年龄 8.0±2.1 个月)中,比较泼尼松龙治疗(I 组,n=4)或阿仑膦酸钠治疗(II 组,n=4,2 例从基线开始治疗,2 例在泼尼松龙治疗失败后开始治疗)在静脉补液和利尿剂治疗基础上,达到正常血钙所需的时间。
基线血清钙水平在 3.8 至 4.77mmol/L 之间。在泼尼松龙组中,尽管 2 例患者在治疗第 7 和 12 天达到正常血钙,但另外 2 例患者尽管治疗 23 和 15 天仍未达到正常血钙,因此改用阿仑膦酸钠治疗。这 4 例患者的泼尼松龙治疗平均持续时间为 14.2±6.7 天(范围 7-23 天)。在阿仑膦酸钠组中,从基线开始治疗的 2 例患者在第 5 天达到正常血钙。另外 2 例患者在改用阿仑膦酸钠后 2 天达到正常血钙。因此,单次口服阿仑膦酸钠后达到正常血钙的平均时间为 3.5±1.7 天(范围 2-5)(p<0.01 与 I 组相比)。
阿仑膦酸钠治疗使正常血钙达到的时间比泼尼松龙治疗提前 4 倍,并缩短了维生素 D 中毒婴儿的住院时间。