CASE REPORT OF AN INFANT WITH SEVERE VITAMIN D DEFICIENCY RICKETS MANIFESTED AS HYPOCALCEMIC SEIZURES
Journal Title: INTERNATIONAL JOURNAL OF ADVANCED MEDICINE - Year 2017, Vol 1, Issue 4
Abstract
Introduction: Hypocalcemic seizures are uncommon in the post-neonatal period. We report an infant with hypocalcemic seizures caused by severe deciency of vitamin D. Case Outline: A three-month-old male infant was admitted in our hospital with recurrent generalized afebrile seizures. At the clinical examination, the infant showed characteristic rachitic signs, so that after a blood sample was taken for laboratory testing, the infant was given infusion of 2 ml/kg of 10% of calcium gluconate at a rate of 0.5 ml/min. The treatment resulted in immediate termination of seizures and normalization of the consciousness of the infant. Blood sample analysis showed extremely low levels of free and total calcium (0.31/1.19mmol/l) and 25(OH)D (<3 ng/ml), elevated alkaline phosphatase (900 U/l) and parathyroid hormone (293 pg/ml), and low calcium/creatinine ratio (mg/mg) in a portion of urine (0.03), while the levels of serum phosphorus, pH, total protein, albumin and creatinine were within the reference range. Wrist X-ray showed typical signs of rickets. In order to fully stabilize calcium homeostasis, along with 2,000 IU of vitamin D3 daily and standard cow's milk formula, calcium gluconate (80 mg/kg daily) was given orally over a period of two weeks. The treatment resulted in complete stabilization of the infant's condition and rapid improvement in laboratory, radiological and clinical ndings of rickets. Conclusion: Generalized convulsions in the afebrile infant represent a serious and etiopathogenically very heterogeneous problem. Extremely rare, as in the case of our patient, it may be due to severe hypocalcemia caused by a deciency of vitamin D.
Authors and Affiliations
Dr. Shafath Ahmed
Keywords
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