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Efficacy and safety of parenteral vitamin D therapy in infants and children with vitamin D deficiency caused by intestinal malabsorption

Annals of Pediatric Endocrinology & Metabolism 2020년 25권 2호 p.112 ~ 117
유새빛, 이예나, 오아름, 유한옥, 최진호,
소속 상세정보
유새빛 ( Yu Sae-Bit ) - University of Ulsan College of Medicine Asan Medical Center Children’s Hospital Department of Pediatrics
이예나 ( Lee Ye-Na ) - University of Ulsan College of Medicine Asan Medical Center Children’s Hospital Department of Pediatrics
오아름 ( Oh A-Rum ) - University of Ulsan College of Medicine Asan Medical Center Children’s Hospital Department of Pediatrics
유한옥 ( Yoo Han-Wook ) - University of Ulsan College of Medicine Asan Medical Center Children’s Hospital Department of Pediatrics
최진호 ( Choi Jin-Ho ) - University of Ulsan College of Medicine Asan Medical Center Children’s Hospital Department of Pediatrics

Abstract


Purpose: Oral supplementation of vitamin D can be inefficient in patients with vitamin D deficiency caused by intestinal malabsorption. This study investigated the efficacy and safety of parenteral vitamin D supplementation in infants and children with vitamin D deficiency caused by intestinal malabsorption.

Methods: This study included 11 patients with vitamin D deficiency who were unresponsive to oral vitamin D or were unable to try oral vitamin D therapy due to underlying conditions. All patients were treated with weekly intramuscular injection of cholecalciferol 50,000 IU. Radiological findings and biochemical parameters including serum calcium, phosphorus, alkaline phosphatase, 25-hydroxyvitamin D3 (25(OH)D3), and parathyroid hormone levels were reviewed retrospectively.

Results: Underlying diseases included small bowel atresia (n=3), necrotizing enterocolitis (n=3), congenital megacolon (n=2), chronic intestinal pseudoobstruction (n=1), congenital mesenteric band (n=1), and Crohn disease (n=1). Three patients exhibited rickets on X-ray findings. The mean duration of treatment was 4.8±2.9 weeks. The alkaline phosphatase levels were decreased from 710±650 IU/L to 442±284 IU/L (P=0.143). The 25(OH)D3 level was increased from 6.0±3.4 ng/mL to 50.4±28.8 ng/mL (P=0.008) after 3 months. Two patients with rickets showed improved radiologic findings after parenteral treatment.

Conclusions: Parenteral vitamin D therapy was effective and safe in patients with vitamin D deficiency caused by intestinal malabsorption. Long-term follow-up is needed to establish the efficacy of parenteral vitamin D therapy in a large number of patients.

키워드

Malabsorption; Rickets; Vitamin D; Vitamin D deficiency

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