When vitamin supplementation would make all the difference

Authors

  • Clara Carvalho Department of Pediatrics, Unidade Local de Saúde Santa Maria https://orcid.org/0000-0002-9315-1363
  • Filipa Carmo Department of Pediatrics, Unidade Local de Saúde Santa Maria https://orcid.org/0000-0003-3490-8773
  • Rosa Martins Department of Pediatrics, Unidade Local de Saúde Santa Maria
  • Eugénia Matos Department of Pediatrics, Unidade Local de Saúde Santa Maria; Pediatric Intensive Care Unit, Department of Pediatrics, Unidade Local de Saúde Santa Maria
  • Erica Torres Department of Pediatrics, Unidade Local de Saúde Santa Maria; Pediatric Intensive Care Unit, Department of Pediatrics, Unidade Local de Saúde Santa Maria
  • Mónica Rebelo Cardiology Service, Department of Pediatrics, Unidade Local de Saúde Santa Maria

DOI:

https://doi.org/10.25753/BirthGrowthMJ.v33.i2.28345

Keywords:

cardiogenic shock, dilated cardiomyopathy, heart failure, hypocalcemia, hypoxic-ischemic encephalopathy, vitamin D, vitamin supplementation

Abstract

Introduction: Dietary intake is insufficient to provide adequate levels of vitamin D during the first year of life and supplementation is required. The main function of calcitriol is to regulate calcium-phosphorus metabolism. Its deficiency can lead to hypocalcemia with severe clinical manifestations.
Case Report: A six-month-old melanodermic female infant, exclusively breastfed until five months of age without cholecalciferol supplementation, was admitted for respiratory distress that progressed to severe bradycardia requiring resuscitation. Cardiac ultrasound was compatible with dilated cardiomyopathy, and the girl was admitted to the Intensive Care Unit. She later developed seizures, and neuroimaging was compatible with hypoxic-ischemic encephalopathy. Laboratory studies revealed hypovitaminosis D and hypocalcemia. Replacement therapy was initiated. Due to lack of improvement and poor prognosis, palliative care was provided, and the patient eventually died.
Discussion/Conclusions: Vitamin D supplementation in the first year of life is essential to prevent calcium-phosphorus metabolism disorders and secondary cardiomyopathy, cardiogenic shock, and even death.

Downloads

Download data is not yet available.

References

Catarino AM, Claro C, Viana I. Vitamina D – Perspetivas Atuais. Revista SPDV 2016; 74(4):345-53.

Lee JY, So T, Thackray J. A Review on Vitamin D Deficiency Treatment in Pediatric Patients. J Pediatr Pharmacol Ther 2013; 18(4):277-91.

Wagner CL, Greer FR. Prevention of rickets and vitamin D deficiency in infants, children and adolescents. Pediatrics 2008; 122:1142-52.

Elsori DH, Hammoud MS. Vitamin D deficiency in mothers, neonates and children. J Steroid Biochem Mol Biol 2018; 175:195-199.

Declaração Portuguesa da Vitamina D. (Assessed February 10, 2021). Available at: http://www.spmi.pt/pdf/Declaracao_ Port_VitD_2009_final.pdf.

Salama MM, El-Sakka AS. Hypocalcemic seizures in breastfed infants with rickets secondary to severe maternal vitamin D. Pakistan Journal of Biological Sciences 2010; 13(9):437-42.

Uday S, Fratzl-Zelman N, Roschger P, Klaushofer K, Chikermane A, Saraff V, et al. Cardiac, Bone and Growth Plate Manifestations in Hypocalcemic Infants: Revealing the Hidden Body of the Vitamin D Deficiency Iceberg. BMC Pediatrics 2018; 18(1): 183.

Moniz M, Rebelo M, Mascarenhas MI, Nunes P, Abadesso C, Loureiro H, et al. Disfunção miocárdica por Défice de Vitamina D. Acta Pediatr Port 2016; 47:162-6.

Casey CF, Slawson DC, Neal LR. Vitamin D Supplementation in Infants, Children, and Adolescents. American Family Physician 2010; 81(6):745-8.

Direção Geral de Saúde. Norma 004/2019, Prevenção e tratamento da Deficiência de Vitamina D. Lisboa: DGS; 2019.

Laranjo S, Trigo C, Pinto FF. Dual etiology of dilated cardiomyopathy: The synergistic role of vitamin D deficiency. Revista Portuguesa de Cardiologia 2014; 3:179e1-179e4.

Maiya S, Sullivan I, Allgrove J, Yates R, Malone M, Brain C, et al. Hypocalcaemia and Vitamin D Deficiency: An Important, but Preventable, Cause of Life-Threatening Infant Heart Failure. Heart 2008; 94:581-4.

Dawodu A, Agarwal M, Hossain M, Kochyil J, Zayed R. Hypovitaminosis D and vitamin D deficiency in exclusively breast-feeding infants and their mother in summer: a justification for vitamin D supplementation of breast-feeding infants. J Pediatr 2003; 142(2):169-73.

Downloads

Published

2024-06-27

How to Cite

1.
Carvalho C, Carmo F, Martins R, Matos E, Torres E, Rebelo M. When vitamin supplementation would make all the difference. REVNEC [Internet]. 2024Jun.27 [cited 2025Feb.23];33(2):127-32. Available from: https://revistas.rcaap.pt/nascercrescer/article/view/28345

Issue

Vol. 33 No. 2 (2024)

Section

Case Reports

License

Copyright (c) 2024 Clara Carvalho

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Copyright and Authors' Rights

All articles published in Nascer e Crescer - Birth and Growth Medical Journal are Open Access and comply with the requirements of funding agencies or academic institutions. For use by third parties, Nascer e Crescer - Birth and Growth Medical Journal adheres to the terms of the Creative Commons License "Attribution - Non-Commercial Use (CC-BY-NC)".

It is the author's responsibility to obtain permission to reproduce figures, tables, etc. from other publications.

Authors must submit a Conflict of Interest statement and an Authorship Form with the submission of the article. An e-mail will be sent to the corresponding author confirming receipt of the manuscript.

Authors are permitted to make their articles available in repositories at their home institutions, provided that they always indicate where the articles were published and adhere to the terms of the Creative Commons license.