Symptomatic Hypocalcemia due to Nutritional Vitamin D Deficiency in Three Adolescents during the COVID-19 Pandemic
Background. Symptomatic hypocalcemia secondary to vitamin D deficiency (VDD) is rare among adolescents without underlying medical disorders, but its prevalence is higher in known risk populations. We report on three adolescent males with low nutritional intake of vitamin D and calcium and limited su...
Saved in:
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-01-01
|
| Series: | Case Reports in Pediatrics |
| Online Access: | http://dx.doi.org/10.1155/2023/3588196 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849703904615333888 |
|---|---|
| author | Sabitha Sasidharan Pillai Lisa Swartz Topor |
| author_facet | Sabitha Sasidharan Pillai Lisa Swartz Topor |
| author_sort | Sabitha Sasidharan Pillai |
| collection | DOAJ |
| description | Background. Symptomatic hypocalcemia secondary to vitamin D deficiency (VDD) is rare among adolescents without underlying medical disorders, but its prevalence is higher in known risk populations. We report on three adolescent males with low nutritional intake of vitamin D and calcium and limited sun exposure who presented with hypocalcemic tetany and muscle cramps due to VDD during the COVID-19 pandemic. Case Reports. Three adolescent males (age range 14 to 16 years) presented with symptomatic hypocalcemia: paresthesia, carpopedal spasms, and muscle cramps. All reported limited dairy intake and sun exposure. Laboratory studies showed mean ionized calcium (iCa) 2.73 mg/dl (range 2.69–2.8), mean phosphorus 4.17 mg/dl (range, 3–5.4), mean parathyroid hormone (PTH) 431.67 pg/mL (range, 320–527), and mean 25-hydroxyvitamin D (25(OH)D) 7.37 ng/mL (range 5.3–10.8). All the patients presented during the COVID-19 pandemic, and one had COVID-19 infection. All were treated with oral calcium and high dose ergocalciferol. Patients 2 and 3 were also treated with intravenous calcium gluconate infusion and oral calcitriol. Conclusion. Severe VDD with symptomatic hypocalcemia can occur among adolescents without underlying medical diagnoses due to dietary and behavioral habits that limit nutritional intake and sun exposure. Risk factors of the patients may have been potentiated by pandemic-related behaviors such as more time indoors at home related to social distancing, as well as diets with limited nutrient intake. Adolescents presenting with nonspecific musculoskeletal symptoms should be screened for VDD and hypocalcemia. Appropriate treatment and preventive measures can stop immediate and long-term complications. |
| format | Article |
| id | doaj-art-13843154d78b4acc9502d5c0fbf1f2e2 |
| institution | DOAJ |
| issn | 2090-6811 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pediatrics |
| spelling | doaj-art-13843154d78b4acc9502d5c0fbf1f2e22025-08-20T03:17:02ZengWileyCase Reports in Pediatrics2090-68112023-01-01202310.1155/2023/3588196Symptomatic Hypocalcemia due to Nutritional Vitamin D Deficiency in Three Adolescents during the COVID-19 PandemicSabitha Sasidharan Pillai0Lisa Swartz Topor1Division of Pediatric EndocrinologyDivision of Pediatric EndocrinologyBackground. Symptomatic hypocalcemia secondary to vitamin D deficiency (VDD) is rare among adolescents without underlying medical disorders, but its prevalence is higher in known risk populations. We report on three adolescent males with low nutritional intake of vitamin D and calcium and limited sun exposure who presented with hypocalcemic tetany and muscle cramps due to VDD during the COVID-19 pandemic. Case Reports. Three adolescent males (age range 14 to 16 years) presented with symptomatic hypocalcemia: paresthesia, carpopedal spasms, and muscle cramps. All reported limited dairy intake and sun exposure. Laboratory studies showed mean ionized calcium (iCa) 2.73 mg/dl (range 2.69–2.8), mean phosphorus 4.17 mg/dl (range, 3–5.4), mean parathyroid hormone (PTH) 431.67 pg/mL (range, 320–527), and mean 25-hydroxyvitamin D (25(OH)D) 7.37 ng/mL (range 5.3–10.8). All the patients presented during the COVID-19 pandemic, and one had COVID-19 infection. All were treated with oral calcium and high dose ergocalciferol. Patients 2 and 3 were also treated with intravenous calcium gluconate infusion and oral calcitriol. Conclusion. Severe VDD with symptomatic hypocalcemia can occur among adolescents without underlying medical diagnoses due to dietary and behavioral habits that limit nutritional intake and sun exposure. Risk factors of the patients may have been potentiated by pandemic-related behaviors such as more time indoors at home related to social distancing, as well as diets with limited nutrient intake. Adolescents presenting with nonspecific musculoskeletal symptoms should be screened for VDD and hypocalcemia. Appropriate treatment and preventive measures can stop immediate and long-term complications.http://dx.doi.org/10.1155/2023/3588196 |
| spellingShingle | Sabitha Sasidharan Pillai Lisa Swartz Topor Symptomatic Hypocalcemia due to Nutritional Vitamin D Deficiency in Three Adolescents during the COVID-19 Pandemic Case Reports in Pediatrics |
| title | Symptomatic Hypocalcemia due to Nutritional Vitamin D Deficiency in Three Adolescents during the COVID-19 Pandemic |
| title_full | Symptomatic Hypocalcemia due to Nutritional Vitamin D Deficiency in Three Adolescents during the COVID-19 Pandemic |
| title_fullStr | Symptomatic Hypocalcemia due to Nutritional Vitamin D Deficiency in Three Adolescents during the COVID-19 Pandemic |
| title_full_unstemmed | Symptomatic Hypocalcemia due to Nutritional Vitamin D Deficiency in Three Adolescents during the COVID-19 Pandemic |
| title_short | Symptomatic Hypocalcemia due to Nutritional Vitamin D Deficiency in Three Adolescents during the COVID-19 Pandemic |
| title_sort | symptomatic hypocalcemia due to nutritional vitamin d deficiency in three adolescents during the covid 19 pandemic |
| url | http://dx.doi.org/10.1155/2023/3588196 |
| work_keys_str_mv | AT sabithasasidharanpillai symptomatichypocalcemiaduetonutritionalvitaminddeficiencyinthreeadolescentsduringthecovid19pandemic AT lisaswartztopor symptomatichypocalcemiaduetonutritionalvitaminddeficiencyinthreeadolescentsduringthecovid19pandemic |