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Exp Clin Endocrinol Diabetes 2017; 125(07): 478-484
DOI: 10.1055/s-0043-109699
Article
© Georg Thieme Verlag KG Stuttgart · New York

The Spectrum of Vitamin D Deficiency: Description of a Family

Francesco Vierucci
1   S.C. Pediatria, Ospedale San Luca, Lucca, Italy
,
Marta Del Pistoia
2   U.O. Pediatria Universitaria, Dipartimento Materno Infantile, Azienda Ospedaliero-Universitaria Pisana, Italy
,
Emioli Randazzo
2   U.O. Pediatria Universitaria, Dipartimento Materno Infantile, Azienda Ospedaliero-Universitaria Pisana, Italy
,
Francesco Massart
2   U.O. Pediatria Universitaria, Dipartimento Materno Infantile, Azienda Ospedaliero-Universitaria Pisana, Italy
,
Giovanni Federico
2   U.O. Pediatria Universitaria, Dipartimento Materno Infantile, Azienda Ospedaliero-Universitaria Pisana, Italy
› Author Affiliations
Further Information

Publication History

received 21 September 2016
revised 07 April 2017

accepted 24 April 2017

Publication Date:
19 July 2017 (online)

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Abstract

Background Vitamin D deficiency represents a global health problem, affecting children and adolescents worldwide.

Objects To confirm that vitamin D deficiency can present as a spectrum of clinical pictures.

Methods We diagnosed nutritional rickets in a 10-month-old infant of Senegal origin with several risk factors for vitamin D deficiency. As many of these factors affected also his cohabitant relatives, we evaluate infant’s family members (mother and 4 brothers) looking for other vitamin D deficiency-related comorbidities.

Results 3 brothers had asymptomatic vitamin D deficiency and 2 of them (9.8 and 13.4 years-old) showed secondary hyperparathyroidism. The fourth brother (11.3 years-old) had nutritional rickets. Their mother was affected by osteomalacia. None of them received vitamin D supplementation.

Conclusion Vitamin D deficiency may present as a spectrum of clinical pictures, representing a continuum ranging from asymptomatic/subtle conditions to overt rickets/osteomalacia. Immigrant families are at high risk for vitamin D deficiency at every age. If a case of symptomatic vitamin D deficiency is recognized, then the evaluation of the all family members is recommended, as they can have the same and/or other risk factors for vitamin D deficiency.

Key words

nutritional rickets - hypocalcemia - hyperparathyroidism - adolescence - osteomalacia
 

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