A spectrum of clinical presentations in seven Japanese patients with vitamin d deficiency.
Recently, the reemergence of vitamin D deficiency in developed countries has been pointed out. Vitamin D deficiency is diagnosed based on the serum 25-hydroxyvitamin D (25OHD) level. However, its normal range is still controversial, making the diagnosis of vitamin D deficiency difficult. Here, we present seven Japanese patients diagnosed with vitamin D deficiency. Three patients complained of leg bowing, and the other four of tetany. The patients with leg bowing were toddlers. Radiographic surveys demonstrated evidence of rickets. Laboratory findings showed decreased levels of serum inorganic phosphorus and increased levels of alkaline phosphatase (ALP) and intact-parathyroid hormone (iPTH). The serum levels of 25OHD were relatively low, ranging from 13 to 15.2 ng/ml. Of the patients with tetany, three were young infants. Laboratory findings showed decreased levels of serum calcium and increased levels of ALP and iPTH. The serum levels of 25OHD were markedly decreased (below 8 ng/ml). Thus, these results indicate that relatively low levels of 25OHD can cause rickets, a symptom of vitamin D deficiency, and that clinicians should therefore carefully evaluate the levels of 25OHD.
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan.
Takuo
T
Kubota
Department of Pediatrics, Toyonaka Municipal Hospital, Osaka, Japan.
Tomoo
T
Kotani
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan.
Yoko
Y
Miyoshi
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan.
Yoko
Y
Santo
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan.
Haruhiko
H
Hirai
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan ; The First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Osaka, Japan.
Noriyuki
N
Namba
Department of Pediatrics, NTT West Osaka Hospital, Osaka, Japan.
Masaaki
M
Shima
Department of Pediatrics, Toyonaka Municipal Hospital, Osaka, Japan.
Kazuo
K
Shimizu
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan.
Shigeo
S
Nakajima
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan.
Keiichi
K
Ozono
25-hydroxyvitamin D; Vitamin D deficiency; hypocalcemia; rickets