Article Text

CALCIUM HOMEOSTASIS IN 40 ADOLESCENTS WITH BETA THALASSAEMIA MAJOR: EFFECTS OF INTRAMUSCULAR INJECTION OF A MEGADOSE OF CHOLECALCIFEROL
  1. A T Soliman1,
  2. A M Adel1,
  3. M Wagdy1,
  4. M AlAli1,
  5. N AlMulla1
  1. 1Department of Pediatrics, Hamad Medical Center, Doha, Qatar

Abstract

Objectives To study calcium homeostasis in 40 adolescent thalassaemic patients and the effect of an intramuscular injection of a megadose of vitamin D3 on serum 25-hydroxycholecalciferol (25-OH-D) concentration and other calcium homeostasis parameters in vitamin D-deficient (VDD) thalassaemic and non-thalassaemic adolescents.

Methods We measured some parameters of calcium homeostasis in 40 adolescents with thalassaemia and 40 non-thalassaemic adolescents. An intramuscular dose (10 000 IU/kg) of cholecalciferol was injected in those with VDD (40 thalassaemic and 26 non-thalassaemic adolescents) and their responses evaluated.

Results Out of 40 thalassaemic individuals, two had hypoparathyroidism and low 25-OH-D and two had hypocalcaemia with hypophosphatemia, high alkaline phosphatase (ALP), high parathyroid hormone (PTH) and low serum 25-OH-D (<20 ng/ml). The rest of the thalassaemic group (n  =  36) had low circulating 25-OH-D concentrations with normal serum calcium and PO4 concentrations. Out of the 40 non-thalassaemic individuals, 26 had VDD (65%). Thalassaemic individuals with VDD had lower circulating PTH and ALP concentrations compared with non-thalassaemic individuals with VDD. An improvement of symptoms related to VDD had been reported in 18/26 of symptomatic thalassaemic and 12/16 of non-thalassaemic individuals at 1–3 months after therapy. After 3 months the serum 25-OH-D level was lower in the thalassaemic group versus the non-thalassaemic group but the majority of patients had 25-OH-D equal to or greater than 20 ng/ml.

Conclusion A high prevalence of VDD was detected in thalassaemic adolescents (100%). An intramuscular megadose of cholecalciferol is safe and effective for the treatment of hypovitaminosis D in thalassaemic and non-thalassaemic adolescents for 3 months but not for 6 months.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.