Pedrosa Cristina, Ferraria Nélia, Limbert Catarina, Lopes Lurdes
Pediatric Endocrinology Unit, Hospital de Dona Estefânia, Lisbon, Portugal.
BMJ Case Rep. 2013 May 31;2013:bcr2012007406. doi: 10.1136/bcr-2012-007406.
Vitamin D deficiency, once thought to be eradicated, is becoming a frequent occurence in children, caused mainly by dietary insufficiency. The classical manifestation is rickets, but in infants severe hypocalcaemia may present as stridor, tetany, seizures or, rarely, heart disease. Here, we describe four infants who presented with complications of severe hypocalcaemia secondary to nutritional vitamin D deficiency. (1) Female, 4 months old, several spasms. (2) Male, 8 days old, generalised tonic-clonic seizure. (3) Male, 9 months old, tetany. (4) Male, 4 months old, cardiogenic shock. The cases highlight the importance of child vitamin D supplementation from birth and throughout childhood. We also note that the vitamin D state should be evaluated by the 25(OH)-D value and not the 1,25(OH)2-D.
维生素D缺乏症曾被认为已被根除，但现在在儿童中却频繁出现，主要是由饮食不足引起的。其典型表现是佝偻病，但在婴儿中，严重低钙血症可能表现为喘鸣、手足搐搦、惊厥，或很少见的心脏病。在此，我们描述了4例因营养性维生素D缺乏继发严重低钙血症并发症的婴儿。（1）女性，4个月大，发作数次痉挛。（2）男性，8日龄，全身性强直阵挛发作。（3）男性，9个月大，手足搐搦。（4）男性，4个月大，心源性休克。这些病例凸显了从出生到整个童年期补充儿童维生素D的重要性。我们还注意到，维生素D状态应由25(OH)-D值而非1,25(OH)2-D来评估。
