Hypocalcemia and tetany caused by vitamin D deficiency in a child with intestinal lymphangiectasia
Journal
Journal of the Formosan Medical Association
Journal Volume
108
Journal Issue
10
Pages
814-818
Date Issued
2009
Author(s)
Abstract
Primary intestinal lymphangiectasia is a rare disease of children, which is characterized by chronic diarrhea and complicated with malnutrition, including fat-soluble vitamin deficiency. We report a girl aged 4 years and 8 months who was diagnosed with the disease by endoscopic duodenal biopsy at 8 months of age. She presented initially with chronic diarrhea at 4 months of age. Generalized edema with hypoalbuminemia frequently occurred despite regular albumin supplements. Multiple vitamins initially were not supplied regularly. Episodes of tetany caused by hypocalcemia developed 4 years after the diagnosis of intestinal lymphangiectasia. Imaging study (long-bone X-ray and dual-energy X-ray absorptiometry) revealed low bone density. Complicated vitamin D deficiency [low serum 25-hydroxy vitamin D concentration (< 12.48 mmol/L, the detection limit)] and secondary hyperparathyroidism were confirmed via blood testing. Vitamin D supplementation for 3 months improved her bone density, secondary hyperparathyroidism and frequent tetany. Vitamin D status should be monitored in patients with intestinal lymphangiectasia. ?2009 Elsevier & Formosan Medical Association.
Other Subjects
vitamin D; article; biopsy; bone density; case report; diet supplementation; drug effect; duodenoscopy; female; human; hypocalcemia; intestine lymphangiectasia; pathology; pathophysiology; photon absorptiometry; preschool child; protein losing gastroenteropathy; secondary hyperparathyroidism; tetany; treatment outcome; vitamin D deficiency; Absorptiometry, Photon; Biopsy; Bone Density; Child, Preschool; Dietary Supplements; Duodenoscopy; Female; Humans; Hyperparathyroidism, Secondary; Hypocalcemia; Lymphangiectasis, Intestinal; Protein-Losing Enteropathies; Tetany; Treatment Outcome; Vitamin D; Vitamin D Deficiency
Type
journal article