A spectrum of clinical presentations in seven Japanese patients with vitamin d deficiency.
A spectrum of clinical presentations in seven Japanese patients with vitamin d deficiency.
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DOI：
10.1297/cpe.15.23
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发表时间：
2006-01-01
期刊：
影响因子：
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通讯作者：
Ozono, Keiichi
中科院分区：
文献类型：
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作者：
Kubota, Takuo;Kotani, Tomoo;Ozono, Keiichi
最近，发达国家再次出现维生素D缺乏症。维生素D缺乏症的诊断依据是血清25-羟基维生素D(25OHD)水平。然而，其正常范围仍然存在争议，这使得维生素D缺乏症的诊断变得困难。在这里，我们介绍7名被诊断为维生素D缺乏症的日本患者。三名患者主诉腿部弯曲，另外四名患者主诉手足抽搐。腿部弯曲的患者是蹒跚学步的儿童。放射检查显示有软骨病的证据。实验室结果显示，血清无机磷水平下降，碱性磷酸酶(ALP)和完整甲状旁腺激素(IPTH)水平上升。血清25OHD水平较低，为13~15.2 ng/ml，其中3例为婴幼儿。实验室结果显示，血清钙水平下降，碱性磷酸酶和甲状旁腺素水平上升。血清25OHD水平明显下降(<8 ng/ml)。因此，这些结果表明，相对较低的25OHD水平会导致软骨病，这是维生素D缺乏的症状，因此临床医生应该仔细评估25OHD的水平。
Recently, the reemergence of vitamin D deficiency in developed countries has been pointed out. Vitamin D deficiency is diagnosed based on the serum 25-hydroxyvitamin D (25OHD) level. However, its normal range is still controversial, making the diagnosis of vitamin D deficiency difficult. Here, we present seven Japanese patients diagnosed with vitamin D deficiency. Three patients complained of leg bowing, and the other four of tetany. The patients with leg bowing were toddlers. Radiographic surveys demonstrated evidence of rickets. Laboratory findings showed decreased levels of serum inorganic phosphorus and increased levels of alkaline phosphatase (ALP) and intact-parathyroid hormone (iPTH). The serum levels of 25OHD were relatively low, ranging from 13 to 15.2 ng/ml. Of the patients with tetany, three were young infants. Laboratory findings showed decreased levels of serum calcium and increased levels of ALP and iPTH. The serum levels of 25OHD were markedly decreased (below 8 ng/ml). Thus, these results indicate that relatively low levels of 25OHD can cause rickets, a symptom of vitamin D deficiency, and that clinicians should therefore carefully evaluate the levels of 25OHD.