title: Formula fed twin infants with recurrent hypocalcemic seizures with vitamin D deficient rickets and hyperphosphatemia.
abstract: Vitamin D deficient rickets is generally known to occur in breast fed infants. And excessive phosphate ingestion is a main cause of late onset hypocalcemia in formula fed infants. Here we introduce 45-day-old formula fed hypocalcemic twins with recurrent seizure attacks. They were diagnosed as having both of vitamin D deficient rickets and hyperphosphatemia. Radiologic findings indicated mild rickets and the twins were treated with calcium and alfacalcidol. After 3-5 months of oral supplementation, medication was discontinued in both twins. They showed normal growth and calcium, phosphorus, and vitamin D levels during the 6-month follow-up period. Twins can be at risk for hypocalcemia because of their high risk of vitamin D deficiency, low birth weight, and premature birth. Therefore twin pregnant women need ingestion of sufficient vitamin D and calcium.
authors.affiliation: Department of Pediatrics, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Byung Wook
authors.initials: BW
authors.lastname: Jo
authors.affiliation: Department of Pediatrics, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Ye Jee
authors.initials: YJ
authors.lastname: Shim
authors.affiliation: Department of Pediatrics, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Jin Hyeok
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Department of Pediatrics, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Jun Sik
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Radiology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Hee Joung
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Heung Sik
authors.initials: HS
authors.lastname: Kim
keywords: Twins; Vitamin D deficiency; Hypocalcemia; Seizures; Rickets