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Vitamin D deficiency cardiomyopathy in Scotland: a retrospective review of the last decade
  1. Lindsay Hunter1,
  2. Richard Ferguson1,
  3. Helen McDevitt2
  1. 1Department of Paediatric Cardiology, Royal Hospital for Children Glasgow, Glasgow, UK
  2. 2Department of Paediatric Bone and Endocrinology, Royal Hospital for Children Glasgow, Glasgow, UK
  1. Correspondence to Dr Helen McDevitt, Paediatric Bone and Endocrinology, Royal Hospital for Children Glasgow, Glasgow G51 4TF, UK; helenmcd{at}doctors.org.uk

Abstract

Objective To determine the incidence, demography and prognosis of vitamin D deficiency dilated cardiomyopathy (DCM) in Scotland over the last decade.

Study design A retrospective review of cases of vitamin D deficiency DCM presenting to a national paediatric cardiac centre between 1 January 2008 and 1 January 2018. The departmental database and electronic and paper case notes were used to identify patients and extract data.

Results Six patients were identified (three male), three of whom were Caucasian. Median age at presentation was 206 days (range 2–268.) All six patients had high serum parathyroid hormone levels (median 45 pmol/L, range 27–120 pmol/L), a sensitive marker of total body calcium deprivation secondary to vitamin D deficiency. All patients demonstrated clinical and echocardiographic improvement following high dose vitamin D treatment. No patients required cardiac transplant, and only one patient required extracorporeal life support as a bridge to recovery. After an initial improvement, one child died at 5 months as a result of respiratory infection. Three patients lived within some of the most deprived areas in Scotland.

Conclusions This case series demonstrates a previously unreported demographic in Scotland, as 50% of cases presented in Caucasian children. Although vitamin D deficiency DCM is relatively rare, it is wholly preventable. Our study confirms that vitamin D deficiency cardiomyopathy is reversible with prompt identification and supplementation. The current implementation of public health policy in the UK is failing to prevent children from developing the most severe manifestation of vitamin D deficiency.

  • vitamin D deficiency
  • cardiomyopathy
  • hypocalcaemia
  • echocardiography
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Footnotes

  • Correction notice This paper has been amended since it was published online. We have further anonymised some cases to ensure no patients can be identified.

  • Contributors HM contributed to the paper by carrying out a review of the literature, data collection and analysis for the bone biochemistry, demographic and population data and writing of the manuscript. LH contributed to the paper by carrying out a review of the literature, data collection and analysis for the echocardiography and demographic data and writing of the manuscript. RF contributed to the paper by carrying out a review of the literature, data collection and analysis for the echocardiography and demographic data and writing of the manuscript. All authors had final approval of the version to be published and agrees to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the article.

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