Severe Symptomatic Vitamin D Deficiency During COVID-19 “Stay at-Home-Orders” in New York City

Weiner, Alyson; Nichols, Presley; Rahming, Virginia; Gopalakrishnamoorthy, Mahalakshmi; Oberfield, Sharon E.; Fennoy, Ilene

doi:10.1177/2333794x221086466

Cited by 1 publication

(1 citation statement)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Symptomatic VDD is rare among adolescents [ 7 ] though it has been described in adolescents with risk factors such as restricted diets or developmental disorders [ 11 ] or limited sun exposure for cultural and religious reasons [ 9 ]. A recent report from New York described two healthy young adolescents who presented with seizures and right knee pain, respectively, due to severe VDD which was attributed to limited diet and reduced sun exposure during COVID-19 pandemic [ 12 ]. Our patients were older than those reported by the New York study, and all presented with tetany.…”

Section: Discussionmentioning

confidence: 99%

Symptomatic Hypocalcemia due to Nutritional Vitamin D Deficiency in Three Adolescents during the COVID-19 Pandemic

Sasidharan Pillai,

Topor

2023

Case Reports in Pediatrics

View full text Add to dashboard Cite

Background. Symptomatic hypocalcemia secondary to vitamin D deficiency (VDD) is rare among adolescents without underlying medical disorders, but its prevalence is higher in known risk populations. We report on three adolescent males with low nutritional intake of vitamin D and calcium and limited sun exposure who presented with hypocalcemic tetany and muscle cramps due to VDD during the COVID-19 pandemic. Case Reports. Three adolescent males (age range 14 to 16 years) presented with symptomatic hypocalcemia: paresthesia, carpopedal spasms, and muscle cramps. All reported limited dairy intake and sun exposure. Laboratory studies showed mean ionized calcium (iCa) 2.73 mg/dl (range 2.69–2.8), mean phosphorus 4.17 mg/dl (range, 3–5.4), mean parathyroid hormone (PTH) 431.67 pg/mL (range, 320–527), and mean 25-hydroxyvitamin D (25(OH)D) 7.37 ng/mL (range 5.3–10.8). All the patients presented during the COVID-19 pandemic, and one had COVID-19 infection. All were treated with oral calcium and high dose ergocalciferol. Patients 2 and 3 were also treated with intravenous calcium gluconate infusion and oral calcitriol. Conclusion. Severe VDD with symptomatic hypocalcemia can occur among adolescents without underlying medical diagnoses due to dietary and behavioral habits that limit nutritional intake and sun exposure. Risk factors of the patients may have been potentiated by pandemic-related behaviors such as more time indoors at home related to social distancing, as well as diets with limited nutrient intake. Adolescents presenting with nonspecific musculoskeletal symptoms should be screened for VDD and hypocalcemia. Appropriate treatment and preventive measures can stop immediate and long-term complications.

show abstract