Vitamin D Deficiency as an Ignored Cause of Hypocalcemia in Acute Illness: Report of 2 Cases and Review of Literature

H. Noto, H. J. Heller
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引用次数: 7

Abstract

We describe the clinical and laboratory findings in 2 cases of hypocalcemia secondary to vitamin D deficiency in intensive care unit and the response of calcium to treatment. We also discuss the mechanism and review pertinent lit- erature. The first patient was admitted due to stroke. Laboratory data included serum calcium 7.6 mg/dl, intact parathyroid hormone (PTH) 891.6 pg/ml, 25-hydroxyvitamin D (25-OH-D) 7 ng/ml (17.5 nmol/l), 1,25-dihydroxyvitamin D (1,25- OH-D) 43 pg/ml (103.2 nmol/l), and corrected QT (QTc) interval 494 msec. After two weeks of treatment with oral cal- cium and ergocalciferol, serum calcium and intact PTH levels and QTc interval normalized. The second patient was trans- ferred for the management of disseminated cytomegalovirus infection. Laboratory work-up revealed serum calcium 7.7 mg/dl, creatinine 4.3 mg/dl, intact PTH 207.5 pg/ml, 25-OH-D <5 ng/ml (<12.5 nmol/l), 1,25-OH-D <10 pg/ml (<24 nmol/l), and QTc interval 505 msec. After treatment for vitamin D deficiency and infection, we observed normalization of creatinine, corrected calcium, intact PTH and QTc interval. The clinical courses were uneventful in both cases. In conclu- sion, we would like to emphasize that vitamin D status should be evaluated in patients with hypocalcemia in acute settings because vitamin D deficiency is common and readily treatable, and there may be clear life-threatening consequences if it is not treated.
维生素D缺乏是急性疾病低钙血症的一个被忽视的原因:附2例报告及文献复习
我们描述了2例在重症监护病房继发于维生素D缺乏症的低钙血症的临床和实验室结果以及钙对治疗的反应。本文还讨论了其作用机理,并对相关文献进行了综述。第一个病人因中风入院。实验室数据包括血钙7.6 mg/dl,完整甲状旁腺激素(PTH) 891.6 pg/ml, 25-羟基维生素D (25-OH-D) 7 ng/ml (17.5 nmol/l), 1,25-二羟基维生素D (1,25- OH-D) 43 pg/ml (103.2 nmol/l),校正QT间期494 msec。口服钙和麦角钙化醇治疗两周后,血清钙和完整PTH水平及QTc间期恢复正常。第二例患者转院治疗弥散性巨细胞病毒感染。实验室检查显示血清钙7.7 mg/dl,肌酐4.3 mg/dl,完整PTH 207.5 pg/ml, 25-OH-D <5 ng/ml (<12.5 nmol/l), 1,25- oh - d <10 pg/ml (<24 nmol/l), QTc间隔505 msec。在治疗维生素D缺乏症和感染后,我们观察到肌酐正常化,校正钙,完整的PTH和QTc间期。两个病例的临床过程都很顺利。总之,我们想强调的是,在急性低钙血症患者中,维生素D的状况应该被评估,因为维生素D缺乏是常见的,而且很容易治疗,如果不治疗,可能会有明显的危及生命的后果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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