International Journal of Clinical Case Reports 2017, Vol.7, No.10, 42-44
42
A Letter Open Access
Neonatal Hypocalcemic Convulsions Secondary to Vitamin D Deficiency
Said Azzoug
1
, Ilyes Bekkaye
2
, Farida Chentli
2
, Djamila Meskine
1
1 Endocrine diseases department Bologhine Hospital Algiers, Algeria
2 Endocrine diseases department Bab El Oued Hospital Algiers, Algeria
Corresponding author email
International Journal of Clinical Case Reports 2017, Vol.7, No.10 doi
Received: 20 Jul., 2017
Accepted: 29 Aug., 2017
Published: 08 Sep., 2017
Copyright © 2017
Azzoug et al., This is an open access article published under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Preferred citation for this article:
Azzoug S., Bekkaye I., Chentli F., and Meskine D., 2017, Neonatal hypocalcemic convulsions secondary to vitamin D deficiency, International Journal of
Clinical Case Reports, 7(10): 42-44 (doi
Abstract
Vitamin D deficiency is a major public health issue affecting large proportions of the population. Therefore, maternal
vitamin D deficiency is not uncommon. Infants born to mothers who are deficient in vitamin D are at risk of developing vitamin D
deficiency and hypocalcaemia. We reported here a case of neonatal hypocalcaemic seizures secondary to vitamin D deficiency. A
25-day old, full term male infant presented two episodes of generalized seizures. Laboratory investigations in blood, revealed low
calcium level at 5.5 mg/dl, elevated phosphatemia level at 9.6 mg/dl and high parathormone (PTH) level at 133.4 pg/ml.
Unfortunately 25 hydroxy vitamin D assay was not available in the infant but it was low in the mother at 12.9 ng/ml. The infant was
commenced on vitamin D and calcium supplements during some weeks which allowed normalization of calcium levels. After several
months of treatment cessation, the infant was doing well, and his development was according to his chronological age. His calcium,
phosphatemia and PTH levels were within normal ranges without any treatment. Hypocalcemia in this infant was presumably due to
vitamin D deficiency as other causes were unlikely. Neonatal hypocalcaemic seizures are a rare presentation of vitamin D deficiency.
This case could have been preventable had the mother been given vitamin D supplementation during pregnancy and early lactation.
Keywords
Neonatal hypocalcemia; Vitamin D deficiency; Neonatal convulsions
Background
Vitamin D deficiency is a public health issue which affects a large proportion of the population. Pregnant women
and their infants are particularly prone to the risks of this deficiency. Maternal and infants vitamin D levels are
highly correlated and low vitamin D levels during pregnancy have been linked to various health outcomes in the
offspring. Few cases of hypocalcaemic seizures secondary to vitamin D deficiency have been reported in the
literature. We reported here, a case of neonatal convulsions secondary to vitamin D deficiency.
1 Observation
A 25 days old, full term male infant presented two episodes of generalized seizures. Physical examination was
within normal. Laboratory investigations in blood, revealed low calcium level at 5.5 mg/dl, elevated phosphatemia
level at 9.6 mg/dl and high parathormone (PTH) level at 133.4 pg/ml (N:15-65). Urinary calcium was low at 7.6
mg/24 hours. Other laboratory results were normal. Unfortunately, 25 hydroxy vitamin D assay was not available
in the infant but it was low in the mother at 12.9 ng/ml. In this infant hypocalcemia was presumably due to
vitamin D deficiency as other causes were unlikely.
The patient was commenced on vitamin D and calcium supplements during some weeks which allowed
normalization of calcium levels.
After treatment cessation for several months, the infant was doing well. His development was according to his
chronological age. His calcium, phosphatemia and PTH levels were within normal ranges without any treatment.
At nine months of age, without treatment, calcemia level was at 10.1mg/dl, phosphatemia level was at 5.6 mg/dl,
and parathormone level was at 20.2 pg/ml.
