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一只小猫维生素D依赖性佝偻病II型的不寻常表现。

Unusual presentation of vitamin D-dependent rickets type II in a kitten.

作者信息

Duplan Florent, Maunder Christina

机构信息

Internal Medicine Department, Langford Veterinary Services, University of Bristol, Langford, Bristol, UK.

出版信息

JFMS Open Rep. 2020 Mar 19;6(1):2055116920910278. doi: 10.1177/2055116920910278. eCollection 2020 Jan-Jun.

Abstract

CASE SUMMARY

A 15-week-old kitten presented with a 1-month history of intermittent generalised tremors and abdominal distension. Hypocalcaemia associated with increased 1,25-vitamin D was consistent with vitamin D-dependent rickets type II. The bone appearance on CT scan was most consistent with the changes typically seen with nutritional secondary hyperparathyroidism and less typical of the changes seen with rickets. Our patient had a positive response to high vitamin D therapy as it remained normocalcaemic 16 months after diagnosis, supporting the diagnosis of rickets.

RELEVANCE AND NOVEL INFORMATION

This case report is an unusual and interesting presentation of rickets in a kitten. Despite the characteristic vitamin D disturbance for rickets type II, the atypical radiographic changes have not been previously reported. In the literature, a positive response to treatment is not commonly seen or follow-up is short. Our case responded well to treatment and was followed for 16 months from the time of diagnosis. This emphasises that the pathophysiology of the condition is not well understood, and that different types of vitamin D-dependent rickets type II may exist. Although the genetic defects responsible for some cases of rickets type I have been identified, this has still not been determined for rickets type II.

摘要

病例摘要

一只15周龄的小猫出现了1个月的间歇性全身性震颤和腹胀病史。与1,25 - 维生素D升高相关的低钙血症与II型维生素D依赖性佝偻病相符。CT扫描的骨骼表现与营养性继发性甲状旁腺功能亢进典型所见的变化最为一致,而与佝偻病所见的变化不太典型。我们的患者对高剂量维生素D治疗有阳性反应,因为诊断后16个月血钙仍保持正常,支持佝偻病的诊断。

相关性和新信息

本病例报告是小猫佝偻病的一种不寻常且有趣的表现。尽管有II型佝偻病典型的维生素D紊乱,但非典型的影像学变化此前尚未见报道。在文献中,对治疗的阳性反应并不常见或随访时间较短。我们的病例对治疗反应良好,从诊断时起随访了16个月。这强调了该病症的病理生理学尚未得到很好的理解,并且可能存在不同类型的II型维生素D依赖性佝偻病。虽然导致一些I型佝偻病病例的基因缺陷已被确定,但II型佝偻病仍未确定。

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