title: Difficulty Achieving Vitamin D Sufficiency With High-Dose Oral Repletion Therapy in Infants With Cholestasis.
abstract: OBJECTIVE
  Oral high-dose repletion vitamin D therapy, also known as stoss therapy, can be effective in the treatment of nutritional vitamin D deficiency rickets in infants and young children without liver disease and in patients with cystic fibrosis. There is no literature about this approach in infants with new-onset cholestasis.
  
  
  METHODS
  This was a retrospective chart review of infants with cholestasis from March 2010 to March 2012 at a pediatric tertiary care center. Four cases satisfied the inclusion criteria, and were described in detail.
  
  
  RESULTS
  All of the patients received oral high-dose repletion therapy with ergocalciferol (vitamin D2) 300,000 IU daily for 2 to 3 days. Follow-up vitamin D levels approximately 4 weeks later showed failure to achieve sufficiency levels (>20 ng/dL) in any patient.
  
  
  CONCLUSIONS
  Unlike infants without liver disease, use of oral high-dose repletion therapy may not be adequate as treatment of vitamin D deficiency in the setting of cholestasis.
authors: *Division of Pediatric Gastroenterology, Sanford Children's Specialty Clinic, Sioux Falls, SD †Division of Pediatric Gastroenterology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH ‡Department of Pediatrics, Division of Pediatric Gastroenterology, University of Iowa, Iowa City.
authors: Melissa
authors: M
authors: Jensen
authors: Maisam
authors: M
authors: Abu-El-Haija
authors: Warren
authors: W
authors: Bishop
authors: Riad M
authors: RM
authors: Rahhal
mesh_terms: D000284:Administration, Oral; D001656:Biliary Atresia / Q000150:complications; D002779:Cholestasis / Q000150:complications*; D004872:Ergocalciferols / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D017211:Treatment Failure; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D019896:alpha 1-Antitrypsin Deficiency / Q000150:complications
chemical_list: D004872:Ergocalciferols; D014807:Vitamin D; C104450:25-hydroxyvitamin D