Asymptomatic Severe Hypocalcemia Secondary to Vitamin D Deficiency in an Elderly Patient

Objective. To describe an asymptomatic presentation of severe hypocalcemia secondary to vitamin D deficiency in an elderly patient.Methods. We describe the presentation and clinical course of an elderly woman with asymptomatic severe hypocalcemia referred to an endocrinology clinic for hyperparathyroidism.Results. The patient is an 83-year-old Caucasian woman who presented to an endocrinology clinic for evaluation of hyperparathyroidism, with an intact PTH of 462 pg/mL (normal range 14–72 pg/mL). The same lab report included a serum calcium of 5.2 mg/dL (normal range 8–10.5 mg/dL). She displayed no signs or symptoms of hypocalcemia. Given the extreme severity of hypocalcemia and her age, she was hospitalized. Vitamin D deficiency was suspected and was subsequently confirmed with undetectable serum levels. The patient remained asymptomatic throughout her hospital stay. Total and ionized calcium levels at discharge were 7.2 mg/dL and 1.03 mmol/L (normal range 1.1–1.4 mmol/L), respectively.Conclusion. Physicians should exercise prudent management with respect to the vitamin D status of the elderly patient, as certain patients may exhibit severe hypovitaminosis D and hypocalcemia without apparent clinical symptoms.

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Prevalence of 25-hydroxyvitamin D deficiency in subgroups of elderly persons with anemia: association with anemia of inflammation

Blood ◽

10.1182/blood-2010-09-309708 ◽

2011 ◽

Vol 117 (10) ◽

pp. 2800-2806 ◽

Cited By ~ 69

Author(s):

Todd S. Perlstein ◽

Reena Pande ◽

Nancy Berliner ◽

Gary J. Vanasse

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Serum Levels ◽

The Elderly ◽

Vitamin D Supplementation ◽

World Health ◽

Elderly Persons ◽

Increased Risk ◽

Health Organization ◽

Anemia Of Inflammation

AbstractAnemia and vitamin D deficiency are conditions that both result in significant morbidity and increase with age. The potential relationship between them remains poorly understood, particularly in the elderly. We used the Third National Health and Nutrition Examination Survey to examine the association of vitamin D deficiency with anemia subtypes in persons aged ≥ 60 years. Vitamin D deficiency was defined as serum levels < 20 ng/mL, and anemia was defined according to World Health Organization criteria. Vitamin D deficiency was associated with anemia prevalence independent of age, sex, or race/ethnicity (odds ratio, 1.47; 95% confidence interval, 1.06-2.05; P = .02) and varied significantly by anemia subtype (P overall = .003). The prevalence of vitamin D deficiency was 33.3% in the nonanemic population, 56% in anemia of inflammation (AI; P = .008), and 33.0% in unexplained anemia (P = .55). Non-Hispanic blacks had a 7-fold increased risk of AI compared with whites, and this was partially attenuated after adjusting for vitamin D deficiency. These data show that vitamin D deficiency is associated with specific subtypes of anemia in the elderly, especially in those with AI. Vitamin D may suppress inflammatory pathways, and studies to determine whether vitamin D supplementation ameliorates AI are warranted.

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Vitamin D and PTH: data from a cross-sectional study in an equatorial population

Endocrine Connections ◽

10.1530/ec-20-0206 ◽

2020 ◽

Vol 9 (7) ◽

pp. 667-675

Author(s):

Natércia Neves Marques de Queiroz ◽

Franciane Trindade Cunha de Melo ◽

Fabrício de Souza Resende ◽

Luísa Corrêa Janaú ◽

Norberto Jorge Kzan de Souza Neto ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Hypovitaminosis D ◽

Serum Levels ◽

Cross Sectional Study ◽

Vitamin D Insufficiency ◽

Institute Of Medicine ◽

Sectional Study ◽

Cross Sectional ◽

Endocrine Society

Objective: Investigate the prevalence of vitamin D deficiency in an equatorial population through a large-sample study. Methods: Cross-sectional study with 30,224 healthy individuals from the North Region, in Brazil (Amazônia – state of Pará), who had 25-hydroxy-vitamin D (25(OH)D) and intact parathyroid hormone (PTH) serum levels measured by immunoassay method. Those with history of acute or chronic diseases were excluded. Abnormal levels of calcium, creatinine, glycemia and albumin were also exclusion criteria. Results: 25(OH)D levels were 29.1 ± 8.2 ng/mL and values <12.7 ng/mL were equal to < −2 s.d. below average. Hypovitaminosis D was present in 10% of subjects according to the Institute of Medicine (values <20 ng/mL) and in 59%, in consonance with Endocrine Society (values 20–30 ng/mL as insufficiency and <20 ng/mL as deficiency) criteria. Individuals were divided according to four age brackets: children, adolescents, adults and elderly, and their 25(OH)D levels were: 33 ± 9; 28.5 ± 7.4; 28.3 ± 7.7; 29.3 ± 8.5 ng/mL, respectively. All groups differed in 25(OH)D, except adolescents vs adults. Regression model showed BMI, sex, living zone (urban or rural) and age as independent variables to 25(OH)D levels. Comparing subjects with vitamin D deficiency (<20 ng/mL) to those with vitamin D insufficiency (20–30 ng/mL), a difference between PTH levels in these two groups was observed (95.9 ± 24.7 pg/mL vs 44.2 ± 64.5 pg/mL; P < 0.01). Additionally, the most accurate predictive vitamin D level for subclinical hyperparathyroidism in ROC curve was 26 ng/mL. Conclusion: Our equatorial population showed low prevalence of vitamin D hypovitaminosis ranging with age bracket. The insufficient category by Endocrine Society was corroborated by our PTH data.

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Vitamin D Deficiency Among Patients with COVID-19 : Case Series and Recent Literature Review

10.21203/rs.3.rs-29473/v1 ◽

2020 ◽

Cited By ~ 4

Author(s):

Rizaldy Taslim Pinzon ◽

Angela Angela ◽

Andryawan Wahyu Pradana

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Clinical Symptoms ◽

Clinical Signs ◽

Case Series ◽

Hypovitaminosis D ◽

Vitamin D Insufficiency ◽

Laboratory Method ◽

Vitamin D Status ◽

Vitamin D Supplements

Abstract Background The world is now challenging the pandemic of COVID-19 infection. Previous studies showed the plausibility of Vitamin D prophylaxis and therapy for COVID-19, particularly in settings where hypovitaminosis D is frequent. Recent study from Indonesian showed that prevalence of vitamin D deficiency were 23.0%. The examination of Vitamin D status is not a routine in Indonesian clinical setting. Methods This study is a Case Series from confirmed cases of COVID-19 in Bethesda hospital Yogyakarta Indonesia. The data of clinical symptoms, clinical signs, and laboratory examination were obtained from electronic medical record. The vitamin D status was measured by standardized laboratory method. We searched PubMed and Google Scholar for studies that included terms for Vitamin D and COVID-19. Results The data was obtained from 10 participants consist of 50% male and 50% female. The mean of age was 49.6 years. The prevalence of vitamin D deficiency in this case was 90% and 10% of insufficiency. Patients in this case had various symptom and also had various chronic disease as comorbidity. Conclusions The prevalence of vitamin D deficiency in this case series in Bethesda hospital Yogyakarta, Indonesia is 90% and 10% vitamin D insufficiency. We found no clinical evidence that vitamin D supplements are beneficial in preventing or treating COVID-19. Randomized controlled trials need to determine and evaluated this recommendation.

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Vitamin D deficiency in refugees in Italy

Reumatismo ◽

10.4081/reumatismo.2017.991 ◽

2017 ◽

Vol 69 (3) ◽

pp. 101 ◽

Cited By ~ 1

Author(s):

L.G. De Filippis ◽

I. Trombetta ◽

T. Novella ◽

M. Alampi

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

National Level ◽

Hypovitaminosis D ◽

Serum Levels ◽

General Assumption ◽

Microsoft Excel ◽

Italian Case ◽

Vitamin D Levels ◽

Refugees And Asylum Seekers

The objective of the research is to determine 25[OH]D serum levels in refugees in Italy. In the following research we have taken into consideration the results of the monitoring of Vitamin D levels in 46 refugees of the Italian <em>Service for protection of refugees and asylum seekers</em> (SPRAR) system. The indicator of overall vitamin D status used was the circulating serum level of 25(OH)D. Data was analyzed using Microsoft Excel. In the refugees tested, the mean level of 25(OH)D resulted 9.18 ng/mL. The standard deviation was 4.8, with a minimal level of 4.3 and a maximum of 27.4. This figure indicates a clear condition of hypovitaminosis in refugees. While it is general assumption that migratory phenomena may induce the spread of tropical or infectious diseases, widely attested literature demonstrates how chronic pathologies and diseases related to altered lifestyles are the most relevant for Italian case records. Indeed, among the aforementioned diseases, Vitamin D deficiency so far lacks acknowledgement at a national level. Considering the results of lower-than-desirable vitamin D levels found in refugees in Italy, it is necessary to take this parameter into consideration when analyzing individuals who have faced migratory phenomena in order to mitigate the effects of hypovitaminosis D.

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The Association of Disease Activity, BMI and Phase Angle with Vitamin D Deficiency in Patients with IBD

Nutrients ◽

10.3390/nu11112583 ◽

2019 ◽

Vol 11 (11) ◽

pp. 2583 ◽

Cited By ~ 2

Author(s):

Maria Chiara Mentella ◽

Franco Scaldaferri ◽

Marco Pizzoferrato ◽

Antonio Gasbarrini ◽

Giacinto Abele Donato Miggiano

Keyword(s):

Vitamin D ◽

Disease Activity ◽

Vitamin D Deficiency ◽

Phase Angle ◽

Alimentary Tract ◽

Hypovitaminosis D ◽

Serum Levels ◽

Cross Sectional Study ◽

Cross Sectional ◽

Inflammatory Bowel

Hypovitaminosis D is frequently present in inflammatory bowel disease (IBD) with a higher incidence in Crohn’s disease (CD) than in Ulcerative Colitis (UC). Given the involvement of the alimentary tract, many factors can contribute to hypovitaminosis D. The aim of the study was to investigate the association of disease activity, body mass index (BMI) and phase angle with vitamin D deficiency in patients with IBD. A cross-sectional study was conducted on a cohort of 206 IBD patients (October 2016–September 2018). Of these patients, 32.6% were affected by hypovitaminosis D (CD: 38.6%; UC: 25.6%; p < 0.01). Negative and significant associations (p < 0.01) were found between BMI and vitamin D serum levels both in CD and UC patients. BMI represented a determinant of hypovitaminosis D (Odds Ratio (OR) = 1.12, p < 0.01) only in UC patients; phase angle was associated to hypovitaminosis D in both groups (CD: OR = 0.64, p < 0.05; UC: OR = 0.49, p < 0.01). Results of the present study confirm a higher incidence of hypovitaminosis D in patients with CD than in those with UC, and show that nutritional status plays a crucial role in the incidence of vitamin D deficiency in patients with IBD.

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Vitamin D deficiency among patients with COVID-19: case series and recent literature review

Tropical Medicine and Health ◽

10.1186/s41182-020-00277-w ◽

2020 ◽

Vol 48 (1) ◽

Cited By ~ 1

Author(s):

Rizaldy Taslim Pinzon ◽

Angela ◽

Andryawan Wahyu Pradana

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Clinical Symptoms ◽

Case Series ◽

Hypovitaminosis D ◽

Vitamin D Insufficiency ◽

Vitamin D Status ◽

Vitamin D Levels ◽

Laboratory Examinations ◽

The Mean

Abstract Background The world is now challenging the pandemic of COVID-19 infection. This is the third and most extensive pandemic. Previous studies showed the plausibility of vitamin D prophylaxis and therapy for COVID-19, particularly in settings where hypovitaminosis D is frequent. Recent study from Indonesian showed that the prevalence of vitamin D deficiency was 23.0%. The examination of vitamin D status is not a routine in the Indonesian clinical setting. Methods This study is a case series from confirmed cases of COVID-19 in Bethesda Hospital Yogyakarta Indonesia. The data of clinical symptoms, signs and laboratory examinations were obtained from the electronic medical records. The vitamin D status was measured by Enzyme-Linked Fluorescent Assay (ELFA) method. We searched PubMed and Google Scholar for studies that included terms for Vitamin D and COVID-19. Results The data were obtained from 10 participants consisting of 50% male and 50% female. The mean age was 49.6 years. The prevalence of vitamin D deficiency in this study was 90% (vitamin D levels < 20 ng/mL) and 10% of insufficiency (vitamin D levels < 30 ng/mL). Patients in this study had various symptoms such as fatigue (60%), fever (50%), dry cough (40%), non-specific headache (10%), and diarrhea (10%); have no symptoms (20%); and also had the various chronic diseases as comorbidity such as hypertension (40%), diabetes (10%), COPD (10%), and post stroke (10%). Conclusions All of the COVID-19 patients in this study had hypovitaminosis D. The prevalence of vitamin D deficiency in this case series is 90% and only 1 patient (10%) had vitamin D insufficiency. There are many health benefits of vitamin D and very few adverse effects. Randomized controlled trials need to determine and evaluate this recommendation in preventing or treating COVID-19. Clinicians should continue to treat people with vitamin D deficiency especially in managing COVID-19 patients.

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The Role of Vitamin D deficiency in COVID-19 related deaths in BAME, Obese and Other High-risk Categories

10.31232/osf.io/73whx ◽

2020 ◽

Author(s):

Eshani King

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Serum Levels ◽

The Elderly ◽

Optimal Level ◽

Disproportionate Number ◽

Strong Body ◽

The Uk ◽

Tract Infections

It is now widely known that a disproportionate number of COVID-19 related mortalities in the UK havebeen in non-white, BAME populations [2]. The obese, diabetics, hypertensives and the elderly havealso been disproportionately affected. BAME doctors account for 94% of total deaths of doctors butcomprise 44% of doctors [1]. The suggestion that these deaths result from deprivation does not fitwith the high numbers of deaths of doctors and others in higher socio-economic classes; there mustbe a different and perhaps more comprehensive explanation.This review examines the compelling body of evidence strongly implicating varying levels of serumvitamin D levels in the significantly disparate outcomes between different groups of people andbetween different countries. It explores the extent of vitamin D deficiency, highlighting countries andcategories of people most likely to be deficient. It demonstrates that the UK suffers from exceptionallyhigh levels of vitamin D deficiency with serum levels averaging only 20ng/ml, half the optimal level; Itexamines the strong body of existing evidence connecting vitamin D deficiency to increasedrespiratory tract infections highlighting the central epigenetic role of vitamin D in immune systemresponses during a respiratory tract infection with SARS-CoV-2; It reviews research flaggingcorrelations between COVID-19 outcomes and vitamin D deficiency and studies providing the firstdirect evidence linking low vitamin D status with worse outcomes from COVID-19. Cautions regardingfuture trial designs and lack of evidence for toxicity concerns are both discussed. Current UK guidelinesrecommend 400 IU of vitamin D per day whereas 6,000-10,000 IU per day is required to maintainblood levels of 40ng/ml, widely accepted as being the level required to support immunity, optimalhealth, and reduction in all-cause mortality. The financial cost of vitamin D deficiency in the UK hasbeen estimated at around £20 billion per annum.

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Association Of Hyponatremia And Hypovitaminosis D In Ambulatory Adults

Journal of Medical Biochemistry ◽

10.1515/jomb-2015-0003 ◽

2015 ◽

Vol 34 (4) ◽

pp. 450-454 ◽

Cited By ~ 1

Author(s):

Gianfranco Cervellin ◽

Gianluca Salvagno ◽

Laura Bonfanti ◽

Patrizia Bonelli ◽

Gian Cesare Guidi ◽

...

Keyword(s):

Vitamin D ◽

General Population ◽

Vitamin D Deficiency ◽

Serum Sodium ◽

Serum Vitamin ◽

Hypovitaminosis D ◽

Serum Levels ◽

Total Vitamin ◽

Serum Vitamin D ◽

And Gender

SummaryBackground:Hyponatremia and vitamin D deficiency are frequent disorders, and both have been associated with gait disturbances, falls and fractures. The aim of this study was to evaluate the existence of an association between serum sodium and vitamin D serum levels.Methods:We performed a retrospective investigation to establish whether hyponatremia and vitamin D deficiency may be associated in a general population of unselected outpatients. An electronic search was performed in the laboratory information systems of the Hospital of Verona and the Hospital of Parma (Italy), to retrieve combined results for total vitamin D and sodium obtained in all outpatients referred for health check-up in the year 2013.Results:Combined results of vitamin D and sodium could be retrieved for 5097 outpatients (3859 females and 1238 males; mean age 64±17 years). Vitamin D deficient subjects displayed significantly lower levels of serum sodium (140 versus 141 mmol/L; p<0.001), along with a significantly higher rate of hyponatremia (6.3% versus 5.1%; p=0.037). Accordingly, hyponatremic subjects had significantly lower levels of serum vitamin D (55 versus 60 nmol/L; p=0.015), along with a significantly higher rate of vitamin D deficiency (41.8% versus 36.1%; p=0.030). A highly significant correlation was found between sodium and total vitamin D after adjustment for age and gender (p<0.001).Conclusions:The results of this study demonstrate for the first time the existence of a significant correlation between the serum levels of sodium and total vitamin D in a general population of unselected outpatients.

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The ADeViD Study: Alzheimer’s Dementia and Vitamin D Study

Neurology and Neurobiology ◽

10.31487/j.nnb.2020.02.07 ◽

2020 ◽

pp. 1-4

Author(s):

Alberto Castagna ◽

Carmen Ruberto ◽

Giovanni Ruotolo ◽

Giuseppe Attisani ◽

...

Keyword(s):

Vitamin D ◽

Elderly Patients ◽

Cognitive Functions ◽

Cognitive Disorders ◽

Hypovitaminosis D ◽

Serum Levels ◽

The Elderly ◽

Cognitive Status ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D

Introduction: Aging is associated with a large increase in the prevalence of hypovitaminosis D. 25- Hydroxyvitamin D, 25(OH)D, is the best indicator for vitamin D status. Its possible role in the pathogenesis of Alzheimer’s disease (AD), the leading cause of dementia in the elderly, is particularly important. The aim of the present study was to examine the association between 25-hydroxyvitamin D (25(OH)D) and cognitive functions in a group of Italian elderly patients affected with AD. Methods: We studied the relationship between 25(OH)D and cognitive functions assessed by MMSE (Mini Mental State Examination) in 150 consecutive elderly patients (F 76 %, age 78,66+ 6,05 years old) attending our Geriatric ambulatory for cognitive disorders with diagnosis of AD. Results: In our sample hypovitaminosis D was present in 100% of the screened patients; 111 patients (74%) had 25(OH)D serum levels inferior to 20 ng/ml; 39 (26%) patients had serum levels included between 20 and 30 ng/ml. After adjustment for age, gender, systolic blood pressure, education, cardiovascular diseases and antihypertensive treatment, a significant relationship was observed between 25(OH)D and cognitive status. MMSE appeared significantly higher in subjects with 25(OH)D serum levels ≥ 20 ng/ml than in those with 25(OH)D < 20 ng/ml (18,42+4,33 vs 12,22+4,44; p=0,000). Conclusion: Our results showed a relationship between 25(OH)D and cognitive impairment in patients with AD, suggesting that 25(OH)D could be involved in the onset of dementia.

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The Prevalence of Vitamin D Defficiency and its Obstetrical Effects. A prospective study on Romanian patients

Revista de Chimie ◽

10.37358/rc.19.4.7097 ◽

2019 ◽

Vol 70 (4) ◽

pp. 1228-1233 ◽

Cited By ~ 1

Author(s):

Roxana Elena Bohiltea ◽

Corina-Aurelia Zugravu ◽

Adrian Neacsu ◽

Dan Navolan ◽

Costin Berceanu ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Pancreatic Insufficiency ◽

Hypovitaminosis D ◽

Serum Levels ◽

Hydroxyvitamin D ◽

Expression Of Genes ◽

Skeletal Homeostasis ◽

A Prospective Study ◽

Inadequate Nutrition

The birth, growth, development, reproduction and senescence under physiological conditions can be achieved without diminishing the role of other important aspects that influence them, only with the support of an optimal diet that is a fundamental requirement nowadays, considering that the health and the nutritional status are in a permanent interdependence. The effects of inadequate nutrition reflect on the expression of genes, influencing the development of certain diseases in childhood and adulthood. Knowing the phases of the gestation period in which the need of certain nutrients is increased, and their absence has the most serious impact on fetal growth and development, allows for the adoption in due time of concrete preventive rules. Disorders associated with lipid malabsorption, such as celiac disease, Crohn�s disease, pancreatic insufficiency, cystic fibrosis and cholestatic disease, are associated with low serum levels of 5-hydroxyvitamin D. Vitamin D deficiency in the newborn can express as deficient skeletal homeostasis, congenital rickets and fractures in the early days of life. A low level of vitamin D during pregnancy seems to increase the risk of preeclampsia, intrauterine growth restriction and gestational diabetes, and in the longer term it seems to affect the bone, immune system and general status. The prevalence of hypovitaminosis D is increasing globally, and the effects on pregnancy and neonatal outcome of the vitamin D deficiency and supplementation are a topical issue, which is currently under investigation.

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