Vitamin D deficiency: A forgotten treatable cause of motor delay and proximal myopathy

2014 ◽  
Vol 36 (1) ◽  
pp. 84-87 ◽  
Author(s):  
Joel Fluss ◽  
Ilse Kern ◽  
Geraldo de Coulon ◽  
Elsa Gonzalez ◽  
Hassib Chehade
2020 ◽  
Vol 20 (1) ◽  
pp. 104 ◽  
Author(s):  
Amit Sharma ◽  
Siddhartha Sinha ◽  
Amit Narang ◽  
Dushyant K. Chouhan ◽  
Sumit Gupta

Proximal muscle weakness is a common presentation in paediatric-orthopaedic clinics and is frequently paired with a vitamin D deficiency diagnosis. Recently, side effects of the extensive use of antiepileptic and antipsychotic drugs such as sodium valproate in childhood disorders are being documented. Sodium valproate causes a time-dependent, drug-induced proximal myopathy. We report a 13-year-old female patient who presented at the Orthopaedic Outpatient Department at Lady Hardinge Medical College, New Delhi, India, in 2019 with an abnormal gait. The patient was taking a combination therapy of sodium valproate, risperidone and trihexyphenidyl for absence seizures and a mood disorder. Following clinical investigations, the patient was diagnosed with proximal myopathy. As a result of elevated serum alkaline phosphatase and creatine kinase myocardial band levels, sodium valproate was replaced with ethosuximide and a carnitine supplementation was prescribed. The patient fully recovered and regained full mobility. Proximal myopathy had been incorrectly managed and assumed to be caused by a vitamin D deficiency.Keywords: Muscle Weakness; Carnitine; Myopathy; Valproic Acid; Vitamin D Deficiency; Gait; Case Report; India.


2019 ◽  
Vol 18 (01) ◽  
pp. 013-016
Author(s):  
Shruti Kakkar ◽  
Suhalika Singla Sahni ◽  
Ruchika Kumar ◽  
Jatinder Singh Goraya

AbstractVitamin D deficiency is an under-recognized cause of motor delays in infants and young children. Retrospective chart review identified 17 infants, 11 boys and 6 girls, aged between 7 and 27 months with motor delays attributable to vitamin D deficiency. Diagnosis of vitamin D deficiency was made on the basis of clinical, radiological, and biochemical findings. Presenting symptoms were delay in motor milestones in 14 and hypocalcemic seizures in 3. On physical examination, clinical signs of rickets were present in all. Neurological examination displayed hypotonia with retained tendon reflexes. Thirteen and ten infants, respectively, underwent radiographical and biochemical investigations, and all had abnormalities consistent with rickets. All infants were treated with 6,00,000 IU of vitamin D. Four infants were lost to follow-up. Rapid recovery of motor development was observed in remaining 13 infants. Vitamin D deficiency should be considered in the differential diagnosis of motor delays in infants and young children.


Author(s):  
Kassim Javaid

Osteomalacia is a disorder of bone mineralization and is due to a lack of vitamin D. Vitamin D is a prohormone formed by the action of UV radiation on the vitamin’s precursor (7-dehydrocholesterol) in the skin. It undergoes two hydroxylation steps to become an active hormone. The commonest cause of osteomalacia is vitamin D deficiency due to a lack of UVB skin exposure. Other causes include malabsorption (coeliac disease and pancreatic insufficiency), obesity, and chronic kidney disease. The typical symptoms of osteomalacia are non-specific bone pain, proximal myopathy, fatigue, and polyarthralgia. This chapter addresses the causes, diagnosis, and management of osteomalacia.


2011 ◽  
Vol 44 (14) ◽  
pp. 22
Author(s):  
WILLIAM E. GOLDEN ◽  
ROBERT H. HOPKINS

2015 ◽  
Vol 21 ◽  
pp. 293-294
Author(s):  
Mara Carsote ◽  
Cristina Capatina ◽  
Alexandra Mihai ◽  
Andreea Geleriu ◽  
Rodica Petris ◽  
...  

Author(s):  
Giuseppe Derosa ◽  
Angela D’Angelo ◽  
Chiara Martinotti ◽  
Maria Chiara Valentino ◽  
Sergio Di Matteo ◽  
...  

Abstract. Background: to evaluate the effects of Vitamin D3 on glyco-metabolic control in type 2 diabetic patients with Vitamin D deficiency. Methods: one hundred and seventeen patients were randomized to placebo and 122 patients to Vitamin D3. We evaluated anthropometric parameters, glyco-metabolic control, and parathormone (PTH) value at baseline, after 3, and 6 months. Results: a significant reduction of fasting, and post-prandial glucose was recorded in Vitamin D3 group after 6 months. A significant HbA1c decrease was observed in Vitamin D3 (from 7.6% or 60 mmol/mol to 7.1% or 54 mmol) at 6 months compared to baseline, and to placebo (p < 0.05 for both). At the end of the study period, we noticed a change in the amount in doses of oral or subcutaneous hypoglycemic agents and insulin, respectively. The use of metformin, acarbose, and pioglitazone was significantly lower (p = 0.037, p = 0.048, and p = 0.042, respectively) than at the beginning of the study in the Vitamin D3 therapy group. The units of Lispro, Aspart, and Glargine insulin were lower in the Vitamin D3 group at the end of the study (p = 0.031, p = 0.037, and p = 0.035, respectively) than in the placebo group. Conclusions: in type 2 diabetic patients with Vitamin D deficiency, the restoration of value in the Vitamin D standard has led not only to an improvement in the glyco-metabolic compensation, but also to a reduced posology of some oral hypoglycemic agents and some types of insulin used.


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