Article Text

HYPOVITAMINOSIS D AND HYPOCALCEMIC SEIZURES IN INFANCY
  1. R K Marwaha1,
  2. S Aneja2,
  3. A Seth2,
  4. P Mehrotra2,
  5. B Singhla2,
  6. A Gani3,
  7. N Tandon3,
  8. B Sharma1
  1. 1Department of Endocrinology and Thyroid Research Center, Institute of Nuclear Medicine and Allied Sciences, Defence Research and Development Organisation, Ministry of Defence, Delhi, India
  2. 2Department of Pediatrics, Kalawati Saran Hospital, Delhi, India
  3. 3Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Delhi, India

Abstract

Background Hypocalcemia accounts for majority of neonatal seizures reporting to the emergency ward of our hospital. In view of the above, the role of Vitamin D deficiency in causation of neonatal hypocalcemic seizures was evaluated.

Methodology A total of 60 infants with hypocalcemic seizures along with their mothers (study group) and 60 healthy breast-fed infants with their lactating mothers (control group) underwent concurrent clinical, biochemical, and hormonal evaluation to assess the calcium-vitamin D-PTH Axis.

Results Clinical and radiological features of rickets were present in 13.3% and 30.2% respectively in study infants. The mean serum 25(OH) D values in study mothers (6.54±5.32 ng/ml) and their infants (4.92±4.62 ng/ml) were significantly lower than those of control mother-infant pairs [9.06±4.78 ng/ml; 9.03±4.63 ng/ml; (p<0.001)]. Serum 25(OH) D<10 ng/ml was found in 83.3% study mothers and 90% study infants respectively while elevated PTH levels (>54 pg/ml) were seen in 59.3% mothers and 75% infants respectively. A strong positive correlation of 25(OH) D levels between mothers and their infants, was seen in both the study and control populations (P<0.001). 48 (94.1%) infants born to 51 mothers with 25 (OH) D<10 ng/ml had serum 25(OH) D<10 ng/ml in contrast to 28.7% infants born to mothers with 25(OH)D>10 ng/ml.

Conclusions Vitamin D deficiency appears to be a major cause of hypocalcemic seizures in infants. Infants born to Vitamin D deficient mothers are at significantly higher risk to develop hypocalcemic seizures.

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