scholarly journals Study of serum calcium, phosphorus and vitamin D status in multitransfused β-thalassemia major children and adolescents of Jharkhand, India

2019 ◽  
Vol 6 (2) ◽  
pp. 598
Author(s):  
Zeeshan Ahmed ◽  
Pushpanjali . ◽  
Md. Shahnawaz Kausar ◽  
Doyel Sinha
Keyword(s):  
Vitamin D ◽  
Blood Transfusion ◽  
Serum Calcium ◽  
Thalassemia Major ◽  
Mean Values ◽  
Frequent Monitoring ◽  
Standard Population ◽  
Vitamin D Levels ◽  
Calcium Phosphorus ◽  
The Difference

Background: The pattern of levels of calcium, phosphorous and vitamin D levels among the patients with thalassemia major undergoing repeated blood transfusions remain unexplored. Only very few studies have been undertaken among Indian population. The present study was an attempt to determine the levels of calcium, phosphorous and vitamin D levels among thalassemia major patients undergoing repeated multiple transfusions.Methods: In a prospective observational study, 65 patients suffering from β-thalassemia major, aged 2-18 years, having undergone regular blood transfusion and chelation therapy, were evaluated for the levels of serum calcium, phosphorus and vitamin D and the values were compared to the standard values of the same.Results: The mean values of serum calcium (6.72±0.66), phosphorous (5.51±1.07) and vitamin D (13.12±2.9) were significantly lower in our patients as compared to that of standard population values, the difference in each being statistically significant (p<0.05).Conclusions: It is evident from the present study that the levels of calcium, phosphorous and vitamin D are deficient among β-thalassemia major patients on repeated blood transfusion. The deficiencies may be due to iron overload or due to nutritional deficiency. Frequent monitoring and supplementation in deficient states is recommended.

Late Onset Hypocalcemic Seizures in Formula-Fed, Vitamin D Deficient Babies: Revisited

2020 ◽  
Vol 34 (1-2) ◽  
pp. 15-18
Author(s):  
Umar Amin Qureshi ◽  
Abdus Sami Bhat ◽  
Muzaffar Jan ◽  
Uruj Qureshi
Keyword(s):  
Vitamin D ◽  
Breast Feeding ◽  
Serum Calcium ◽  
Late Onset ◽  
Response To Treatment ◽  
Total Serum ◽  
Total Serum Calcium ◽  
Vitamin D Levels ◽  
Calcium Phosphorus ◽  
25 Oh Vitamin D

Purpose: Late onset neonatal hypocalcemia (LNH) is defined as hypocalcemia detected after day 3 of life. Its occurrence in babies fed with cow’s milk is well understood. Since the advent of modern-day formulas, the incidence has however decreased. Methods: A prospective descriptive study (January 2017 to December 2017) of LNH seizures in neonates was conducted. LNH was defined as the total serum calcium of less than 7 mg/dL in preterm or less than 8 mg/dL in term newborns after 72 h of life. Results: 14 neonates were presented with myoclonic and focal seizures due to late hypocalcemia. All were formula fed. Their mean serum calcium, phosphorus, alkaline phosphatase, magnesium, 25-OH vitamin D, intact PTH levels were 4.93 mg/dL, 9.19 mg/dL, 244 U/L, 1.2 mg/dL, 30 nmol/L, 38.6 pg/mL, respectively. Mean maternal vitamin D levels were 43 nmol/L. Mean hospital stay was 4 days. Clinical response to treatment was brisk in those who were able to shift to total breast feeding early. Conclusions: LNH in formula-fed and vitamin D deficient babies is not uncommon. Emphasis should be laid on exclusive breast feeding even in vitamin D deplete mothers. However, mothers at risk should be supplemented with vitamin D during pregnancy.

scholarly journals Assessment of serum vitamin D levels in Egyptian children with beta-thalassemia major

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Ghada Saad Abdelmotaleb ◽  
Ola Galal Behairy ◽  
Khalid Eid Abd El Azim ◽  
Dalia Mohamed Abd El-Hassib ◽  
Tasbeh Mohamed Hemeda
Keyword(s):  
Body Mass Index ◽  
Vitamin D ◽  
Body Mass ◽  
Serum Calcium ◽  
Serum Levels ◽  
Thalassemia Major ◽  
Beta Thalassemia ◽  
Beta Thalassemia Major ◽  
Vitamin D Levels ◽  
25 Oh Vitamin D

Abstract Background Beta-thalassemia major patients are at increased risk of complications including endocrinopathies and bone disease due to iron overload. So, this study aimed to assess the growth parameters, serum levels of 25-OH-vitamin D, calcium, and phosphorous in children with beta-thalassemia major. This was a case-control study that included 55 children with beta-thalassemia major compared with 30 sex- and age-matched healthy children that served as a control group. All enrolled children were subjected to full history taking, clinical examination including anthropometric measurements, and laboratory investigations including complete blood count, serum ferritin, levels of serum calcium, phosphorus, and 25-OH-vitamin D. Results Body mass index was statistically significantly lower in the thalassemic group (P < 0.001). It was observed that vitamin D levels were significantly lower in thalassemic patients than in controls (P value < .0001). The mean serum 25-OH-vitamin D levels were 19.84 ± 5.79 ng/ml and 44.98 ± 5.77 ng/ml, respectively; 22 cases (40%) had insufficient vitamin D, and 5 cases (9%) had deficient vitamin D. Regarding serum calcium and phosphorous, there was no significant difference between the thalassemic and control groups. Conclusion Children with beta-thalassemia major had low body mass index and metabolic abnormality in the form of lower serum levels of vitamin D that signify the importance of therapeutic interventions.

scholarly journals A Study of Vitamin D and Calcium Level in Beta Thalassemia Major in Duhok Province

2019 ◽  
Vol 7 (11) ◽  
pp. 1924
Author(s):  
Ghorbat Saleh Ali ◽  
Malika Kassem Najeeb ◽  
Amad M. Saleh Jubrail ◽  
Zeliha Selamoğlu
Keyword(s):  
Vitamin D ◽  
Blood Transfusion ◽  
Vitamin D Deficiency ◽  
Serum Calcium ◽  
Colorimetric Method ◽  
Thalassemia Major ◽  
Total Serum ◽  
Control Group ◽  
Significant Difference ◽  
25 Hydroxy Vitamin D

β-thalassemia major is severe hemolytic anemia which requires repeated blood transfusion and for survival, which leading to iron overload. Serious complications due to iron over load are recognized in the thalassemia patients. objectives Vitamin D and calcium are important factors for homeostasis of calcium in this study. This study was conducted for a period of two year including from patients with β- thalassemia major from Duhok Thalassemia Centre between 2014 -2015. Thirty eighth β- thalassemia major patients and thirty eighth persons with age- matched as control group were enrolled in the study. Serum concentration of 25- hydroxy vitamin D and calcium were estimated by enzyme linked fluorescent assay and colorimetric method, respectively. In patients, the level of serum 25- hydroxy vitamin D was significantly lower 11.11±4.36 ng/mL compared with control group (14.03±5.96ng/mL). Vitamin D deficiency is observed about 94.73% in patients. The mean level of serum calcium in patients group is 7.9±0.47mg/dL and 8.98±0.77 mg/dL in control group. There was a statistically significant difference in serum calcium value between patients and control group. 44.73% of patients have hypocalcaemia. This study demonstrated a high prevalence of Vitamin D deficiency and low total serum calcium levels in thalassemia patients with a significantly lower than healthy group. Hypocalcemia and vitamin D deficiency may be results from the negative effect of the repeated blood transfusion and malnourishment.

The Effects of Injected Vitamin D on Prognosis of Patients with Urosepsis

2018 ◽  
Vol 50 (05) ◽  
pp. 383-388
Author(s):  
Abolfazl Jokar ◽  
Koorosh Ahmadi ◽  
Ali Taherinia ◽  
Farshideh Didgar ◽  
Fatemeh Kazemi ◽  
...  
Keyword(s):  
Vitamin D ◽  
Uric Acid ◽  
Standard Treatment ◽  
Vital Signs ◽  
Control Group ◽  
Vitamin D Levels ◽  
Significant Difference ◽  
Calcium Phosphorus ◽  
The Difference ◽  
And Control

AbstractThe aim of this study was to evaluate the effect of prescribing vitamin D on improving the symptoms of patients diagnosed with urosepsis. The participants were randomly divided into two equal groups (each consisting of 50 patients). The patients in the first group received standard treatment with 300 000 units of injected vitamin with a volume of 1 cc. As for the patients in the second group, they received standard treatment along with 1 cc normal saline injected to them as placebo. Vital signs of the patients were checked every 6 h, while their CBC, EXR, CRP, creatinine, urea, and uric acid were checked 0, 24, 48, and 72 h following the interventions. Calcium, phosphorus, and vitamin D levels were measured 72 h following injection of the medicine. A significant difference was observed between the two groups in terms of the number of WBC’s in 24th, 48th, and 72nd hours. A similarly significant difference was reported between the case and control group in terms of the average BUN within 24th, 48th, and 72nd hours. The difference observed between the two groups in terms of average Cr within the 0th, 24th, 48th, and 72nd hours and in terms of days of hospitalization was also significant. Considering these results and keeping in mind the fact that no particular side effects were reported as a result of utilizing muscular injections of vitamin D and the easy and cheap use of this medicine, it can be used in auxiliary treatment of patients with urosepsis.

scholarly journals An Unusual Case of Hypercalcemia Associated with Graves’ Disease and Vitamin D Deficiency

2011 ◽  
Vol 4 ◽  
pp. CMED.S7116 ◽  
Author(s):  
Evgenia Korytnaya ◽  
Nagashree Gundu Rao ◽  
Jane V. Mayrin
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Vitamin D Deficiency ◽  
Serum Calcium ◽  
Graves Disease ◽  
Hydroxyvitamin D ◽  
Vitamin D Levels ◽  
Calcium Phosphorus ◽  
25 Hydroxyvitamin D ◽  
25 Oh Vitamin D

Objective To present a case of hypercalcemia associated with thyrotoxicosis in a patient with vitamin D deficiency and review biochemical changes during the course of treatment. Methods We report a case, describe the changes in serum calcium, phosphorus, parathyroid hormone in Graves’ disease and concomitant Vitamin D deficiency. We compare our findings to those reported in literature. Results Our patient had hypercalcemia secondary to thyrotoxicosis alone, which was confirmed by low parathyroid hormone level and resolution of hypercalcemia with treatment of thyrotoxicosis. The case was complicated by a concomitant vitamin D deficiency. Serum calcium elevation in patients with thyrotoxicosis occurs secondary to hyperthyroidism alone or due to concurrent hyperparathyroidism. Hypercalcemia from thyrotoxicosis is usually asymptomatic and is related to bone resorption. Vitamin D deficiency can be seen in patients with thyrotoxicosis because of accelerated metabolism, poor intestinal absorption and increased demand during bone restoration phase. Coexistence of hypercalcemia and Vitamin D deficiency in patients with thyrotoxicosis is rare, but possible, and 25-hydroxyvitamin D levels should be checked. The definite treatment for hypercalcemia in thyrotoxicosis is correction of thyroid function. Conclusion Hypercalcemia in thyrotoxicosis should be distinguished from concomitant hyperparathyroidism and confirmed by resolution of hypercalcemia with control of thyrotoxicosis. Patients with hypercalcemia and thyrotoxicosis may also have vitamin D deficiency and 25-OH Vitamin D levels should be checked.

Status of Serum calcium, phosphorus and Vitamin D

2012 ◽  
Vol 2 (7) ◽  
pp. 329-330
Author(s):  
Saira Baloch ◽  
◽  
Bikha Ram Devrajani ◽  
Aneela Atta-ur-Rahman
Keyword(s):  
Vitamin D ◽  
Serum Calcium ◽  
Calcium Phosphorus

scholarly journals P114 Effect of vitamin D on parathyroid hormone, serum calcium and bone mineral density in patients with primary hyperparathyroidism being managed conservatively

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Mahrukh Khalid ◽  
Vismay Deshani ◽  
Khalid Jadoon
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Bone Mineral ◽  
Serum Calcium ◽  
Mineral Density ◽  
Neck Of Femur ◽  
Vitamin D Levels ◽  
Significant Difference

Abstract Background/Aims  Vitamin D deficiency is associated with more severe presentation of primary hyperparathyroidism (PTHP) with high parathyroid hormone (PTH) levels and reduced bone mineral density (BMD). We analyzed data to determine if vitamin D levels had any impact on PTH, serum calcium and BMD at diagnosis and 3 years, in patients being managed conservatively. Methods  Retrospective analysis of patients presenting with PHPT. Based on vitamin D level at diagnosis, patients were divided into two groups; vitamin D sufficient (≥ 50 nmol/L) and vitamin D insufficient (≤ 50 nmol/L). The two groups were compared for age, serum calcium and PTH levels at diagnosis and after mean follow up of 3 years. BMD at forearm and neck of femur (NOF) was only analyzed in the two groups at diagnosis, due to lack of 3 year’s data. Results  There were a total of 93 patients, 17 males, mean age 70; range 38-90. Mean vitamin D level was 73.39 nmol/L in sufficient group (n = 42) and 34.48 nmol/L in insufficient group (n = 40), (difference between means -38.91, 95% confidence interval -45.49 to -32.33, p &lt; 0.0001). There was no significant difference in age, serum calcium and PTH at the time of diagnosis. After three years, there was no significant difference in vitamin D levels between the two groups (mean vitamin D 72.17 nmol/L in sufficient group and 61.48 nmol/L in insufficient group). Despite rise in vitamin D level in insufficient group, no significant change was observed in this group in PTH and serum calcium levels. BMD was lower at both sites in vitamin D sufficient group and difference was statistically significant at NOF. Data were analyzed using unpaired t test and presented as mean ± SEM. Conclusion  50% of patients presenting with PHPT were vitamin D insufficient at diagnosis. Vitamin D was adequately replaced so that at 3 years there was no significant difference in vitamin D status in the two groups. Serum calcium and PTH were no different in the two groups at diagnosis and at three years, despite rise in vitamin D levels in the insufficient group. Interestingly, BMD was lower at forearm and neck of femur in those with sufficient vitamin D levels and the difference was statistically significant at neck of femur. Our data show that vitamin D insufficiency does not have any significant impact on PTH and calcium levels and that vitamin D replacement is safe in PHPT and does not impact serum calcium and PTH levels in the short term. Lower BMD in those with adequate vitamin D levels is difficult to explain and needs further research. Disclosure  M. Khalid: None. V. Deshani: None. K. Jadoon: None.

scholarly journals Vitamin D status in children with autoimmune thyroiditis

2017 ◽  
Vol 4 (5) ◽  
pp. 1595
Author(s):  
Gomathi Priya J ◽  
Seenivasan Venkatasamy ◽  
Karamath S Pyarejan ◽  
Jayachandran K.
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Serum Calcium ◽  
Autoimmune Thyroiditis ◽  
Causal Factor ◽  
Vitamin D Status ◽  
Hydroxyvitamin D ◽  
Vitamin D Levels ◽  
Significant Difference ◽  
25 Hydroxyvitamin D

Background: Deficiency of 25 hydroxyvitamin D has been linked with predisposition to autoimmune disorders. Also, vitamin D has been found to be a causal factor in many autoimmune diseases. Objective of the study was to investigate vitamin D status in children with autoimmune thyroiditis attending endocrinology OPD at a tertiary centre in southern India.Methods: It is a case control study done in which 75 children (70 female, 5 male) with age and sex matched healthy controls were chosen. Free thyroxine, TSH, anti TPOAb, anti TGAb, 25 hydroxyvitamin D, serum calcium, phosphorus, alkaline phosphatase levels were estimated in both cases and control subjects. Children with anti TPO or anti TG positivity were divided into four groups based on their level of antibody titers.Results: The mean age in cases was 9.8±0.34 years. 25(OH)D levels were significantly lower in cases (15.07±1.14 ng/ml) compared to controls (17.82±1.13 ng/ml) (p<0.0006). Mean serum calcium levels in cases (9.35±0.16 mg/dl) were significantly lower when compared to controls (9.73±0.14 mg/dl) (p<0.0005). Similarly mean serum alkaline phosphatase level in cases (184.97±11.10 IU/L) were significantly elevated when compared with controls (122.37±6.82 IU/L) (p<0.0001). However, there was no significant difference in serum phosphorus levels between cases (4.42±0.10 mg/dl) and controls (4.43±0.14 mg/dl) (p=0.83). There was no significant difference in vitamin D level among the groups in both anti TPO (p< 0.283) and anti TG (p<0.148).Conclusions: The significant decrease in vitamin D levels in cases signifies that 25(OH)D may be an independent causal factor related to the autoimmunity in thyroid diseases. 

Renal osteodystrophy

2013 ◽  
pp. 1274-1282
Author(s):  
Thomas Bardin ◽  
Tilman Drüeke
Keyword(s):  
Vitamin D ◽  
Bone Turnover ◽  
Serum Calcium ◽  
Renal Osteodystrophy ◽  
Serum Phosphorus ◽  
Osteitis Fibrosa ◽  
Alkaline Phosphatases ◽  
Calcium Phosphorus ◽  
Turnover Markers ◽  
25 Oh Vitamin D

Renal osteodystrophy (ROD) is a term that encompasses the various consequences of chronic kidney disease (CKD) for the bone. It has been divided into several entities based on bone histomorphometry observations. ROD is accompanied by several abnormalities of mineral metabolism: abnormal levels of serum calcium, phosphorus, parathyroid hormone (PTH), vitamin D metabolites, alkaline phosphatases, fibroblast growth factor-23 (FGF-23) and klotho, which all have been identified as cardiovascular risk factors in patients with CKD. ROD can presently be schematically divided into three main types by histology: (1) osteitis fibrosa as the bony expression of secondary hyperparathyroidism (sHP), which is a high bone turnover disease developing early in CKD; (2) adynamic bone disease (ABD), the most frequent type of ROD in dialysis patients, which is at present most often observed in the absence of aluminium intoxication and develops mainly as a result of excessive PTH suppression; and (3) mixed ROD, a combination of osteitis fibrosa and osteomalacia whose prevalence has decreased in the last decade. Laboratory features include increased serum levels of PTH and bone turnover markers such as total and bone alkaline phosphatases, osteocalcin, and several products of type I collagen metabolism products. Serum phosphorus is increased only in CKD stages 4-5. Serum calcium levels are variable. They may be low initially, but hypercalcaemia develops in case of severe sHP. Serum 25-OH-vitamin D (25OHD) levels are generally below 30 ng/mL, indicating vitamin D insufficiency or deficiency. The international KDIGO guideline recommends serum PTH levels to be maintained in the range of approximately 2-9 times the upper normal normal limit of the assay and to intervene only in case of significant changes in PTH levels. It is generally recommended that calcium intake should be up to 2 g per day including intake with food and administration of calcium supplements or calcium-containing phosphate binders. Reduction of serum phosphorus towards the normal range in patients with endstage kidney failure is a major objective. Once sHP has developed, active vitamin D derivatives such as alfacalcidol or calcitriol are indicated in order to halt its progression.

Prevalence and Correction of 25(OH) Vitamin D Deficiency in Peritoneal Dialysis Patients

2005 ◽  
Vol 25 (4) ◽  
pp. 362-366 ◽  
Author(s):  
Nirav Shah ◽  
Judith Bernardini ◽  
Beth Piraino
Keyword(s):  
Vitamin D ◽  
Peritoneal Dialysis ◽  
Calcium Phosphate ◽  
Vitamin D Deficiency ◽  
Muscle Weakness ◽  
Serum Calcium ◽  
Bone Pain ◽  
Vitamin D Levels ◽  
Before And After ◽  
25 Oh Vitamin D

Background Peritoneal dialysis (PD) patients are at risk for 25(OH) vitamin D deficiency due to effluent loss in addition to traditional risk factors. Objectives To measure 25(OH) vitamin D deficiency in prevalent PD patients, to evaluate a replacement dose, and to determine the effects of correction. Methods 25(OH) vitamin D levels were drawn on prevalent PD patients. Patients deficient in 25(OH) vitamin D were given ergocalciferol, 50 000 IU orally once per week for 4 weeks. Patients scored muscle weakness, bone pain, and fatigue on a scale of 0 (none) to 5 (severe). Serum calcium, phosphate, parathyroid hormone (PTH), and 25(OH) vitamin D, and 1,25(OH)2 vitamin D levels were obtained before and after treatment. Results 25(OH) vitamin D levels were measured in 29 PD patients. Deficiency (<15 ng/mL) was found in 28/29 (97%); 25/29 (86%) had undetectable levels (<7 ng/mL). One course of ergocalciferol corrected the deficiency in all but 1 patient, who required a second course. Scores for muscle weakness and bone pain fell from pre- to posttreatment ( p < 0.001). 1,25(OH)2 vitamin D levels rose post ergocalciferol (from 20 to 26 pg/mL, n = 20, p = 0.09). Serum calcium, phosphate, and PTH levels did not change with ergocalciferol. Conclusions Most PD patients had marked 25(OH) vitamin D deficiency, which was readily and safely corrected with one course of 50000 IU ergocalciferol, having no effect on serum calcium, phosphorus, or PTH, but complaints of muscle weakness and bone pain decreased. A prospective, placebo-controlled double-blinded study is needed to determine whether replacement of 25(OH) vitamin D is beneficial in PD patients.

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