Background: Vitamin D is an essential hormone in the homeostasis of calcium. Its main source is sun exposure. Changes in lifestyle and migratory movements have favored the reappearance of vitamin deficiency in our country.
Method: We present three cases of newborn with hypocalcemic seizures, secondary to maternal vitamin D deficiency. Mothers origin was North Africa.
Results: Case 1: 7 days old male brought for several episodes of generalized seizures. Afebrile and without infections signs. In laboratory test, calcemia 5.4 mg/dl with ionic fraction 0.73 mmol/l, phosphate 7.7 mg/dl, 25-hydroxy vitamin D 8.3 ng/ml, and parathormone 29.9 pg/ml. I.v. calcium gluconate was administered. He recovered well. Screening of infectious disease was negative. Maternal levels of 25-OH-VitD were 4.9 ng/ml. It was oriented as hypovitaminosis D with transient hypoparathyroidism. Case 2: 40 days old male referred for generalized seizuresin the last 10 days. He was Afebrile. Laboratory test showed calcium 5.7 mg/dl, phosphate 7.1 mg/dl, 25-hydroxyvitamin D 4 ng/dl, and parathormone 221 pg/ml. Screening for infection disease were normal. Vitamin D levels in his mother were undetectable. Case 3: 34 days old female, admitted for diarrhea. She presented two episodes of generalized seizures. In laboratory test, calcemia 6.1 mg/dl with ionic fraction 0.67 mmol/l, 25-hydroxyvitamin D 7.1 ng/dl and parathormone 69 pg/ml. She required i.v. calcium gluconate, recovering well. Screening for infectious disease was negative. Maternal levels of vitamin D3 were 5.4 ng/ml. She was oriented as hypovitaminosis D with transient hypoparathyroidism.
Conclusions: Vitamin D deficiency in the neonatal period can cause hypocalcemia, which can be manifested acutely compromising patients life. Transient neonatal hypoparathyroidism could be associated and may worse the symptoms and make the diagnosis more difficult. To avoid such complications in newborns is essential the determination of vitamin D levels in risky pregnancies.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology