title: Vitamin D deficiency in children presenting to the emergency department: a growing concern. Vitamin D deficiency in Birmingham's children: presentation to the emergency department.
abstract: BACKGROUND
  The increase in detected vitamin D deficiency appears to be multifactorial: an increasingly multicultural society, reduced exposure to sunlight due to concern about skin cancer and a more sedentary lifestyle and dietary changes within the population.
  
  
  METHODS
  This was a retrospective survey of children found to be vitamin D deficient after attending the emergency department from March 2009 until March 2010. These data were then subdivided according to their age, ethnic origin, presenting complaint and biochemical associated features.
  
  
  RESULTS
  We identified 89 patients with a low vitamin D level (total vitamin D levels less than 50 nmol/l), with 83% of those having very low vitamin D levels (less than 25 nmol/l). The most common presenting features were abdominal pain (19%), a seizure (17%) and limb pain (15%). The most common ethnic origins in our series were Pakistani (37%) followed by black African (11.2%).
  
  
  CONCLUSIONS
  Vitamin D deficiency should be considered in children with pigmented skin presenting with a range of symptoms. The detected vitamin D deficiency probably represents only a very small proportion of the vitamin D deficiency in children in Birmingham.
authors.affiliation: SPR Paediatric ED Emergency Department, Birmingham Children's Hospital, Birmingham, UK. lisakehler@doctors.net.uk
authors.forename: Lisa
authors.initials: L
authors.lastname: Kehler
authors.forename: Sapna
authors.initials: S
authors.lastname: Verma
authors.forename: Ruth
authors.initials: R
authors.lastname: Krone
authors.forename: Emily
authors.initials: E
authors.lastname: Roper
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000453:epidemiology; D007223:Infant; D008297:Male; D010146:Pain / Q000209:etiology; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood; D015995:Prevalence; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology; D014807:Vitamin D / Q000097:blood; D014808:Vitamin D Deficiency / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology
chemical_list: D010281:Parathyroid Hormone; D010710:Phosphates; D014807:Vitamin D