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Nutrients Apr 2022Vitamin D is essential for the normal mineralization of bones during childhood. Although diet and adequate sun exposure should provide enough of this nutrient, there is... (Review)
Review
Vitamin D is essential for the normal mineralization of bones during childhood. Although diet and adequate sun exposure should provide enough of this nutrient, there is a high prevalence of vitamin D deficiency rickets worldwide. Children with certain conditions that lead to decreased vitamin D production and/or absorption are at the greatest risk of nutritional rickets. In addition, several rare genetic alterations are also associated with severe forms of vitamin-D-resistant or -dependent rickets. Although vitamin D3 is the threshold nutrient for the vitamin D endocrine system (VDES), direct measurement of circulating vitamin D3 itself is not a good marker of the nutritional status of the system. Calcifediol (or 25(OH)D) serum levels are used to assess VDES status. While there is no clear consensus among the different scientific associations on calcifediol status, many clinical trials have demonstrated the benefit of ensuring normal 25(OH)D serum levels and calcium intake for the prevention or treatment of nutritional rickets in childhood. Therefore, during the first year of life, infants should receive vitamin D treatment with at least 400 IU/day. In addition, a diet should ensure a normal calcium intake. Healthy lifestyle habits to prevent vitamin D deficiency should be encouraged during childhood. In children who develop clinical signs of rickets, adequate treatment with vitamin D and calcium should be guaranteed. Children with additional risk factors for 25(OH)D deficiency and nutritional rickets should be assessed periodically and treated promptly to prevent further bone damage.
Topics: Calcifediol; Calcium; Child; Cholecalciferol; Humans; Infant; Pediatrics; Rickets; Vitamin D; Vitamin D Deficiency; Vitamins
PubMed: 35565821
DOI: 10.3390/nu14091854 -
Journal of Cystic Fibrosis : Official... Oct 2019Vitamin D deficiency is a common finding in individuals with cystic fibrosis (CF), despite routine supplementation. Hypovitaminosis D is often the result of fat... (Review)
Review
Vitamin D deficiency is a common finding in individuals with cystic fibrosis (CF), despite routine supplementation. Hypovitaminosis D is often the result of fat malabsorption, but other contributors include increased latitude, poor nutritional intake, decreased sun exposure, impaired hydroxylation of vitamin D, and non-adherence to the prescribed vitamin D regimen. Vitamin D is critical for calcium homeostasis and optimal skeletal health, and vitamin D deficiency in CF can lead to skeletal complications of osteopenia and osteoporosis. Over time, our understanding of treatment regimens for vitamin D deficiency in CF has evolved, leading to recommendations for higher doses of vitamin D to achieve target levels of circulating 25-hydroxyvitamin D. There is also some evidence that vitamin D deficiency may have non-skeletal consequences such as an increase in pulmonary exacerbations. The exact mechanisms involved in the non-skeletal complications of vitamin D deficiency are not clearly understood, but may involve the innate immune system. Future clinical studies are needed to help address whether vitamin D has a role in CF beyond skeletal health.
Topics: Cystic Fibrosis; Humans; Vitamin D Deficiency
PubMed: 31679731
DOI: 10.1016/j.jcf.2019.08.022 -
International Journal of Laboratory... Apr 2022In this review of megaloblastic anemia (MA), an overview of vitamin B and folate body requirements, biochemical pathways, and laboratory testing strategies will be... (Review)
Review
In this review of megaloblastic anemia (MA), an overview of vitamin B and folate body requirements, biochemical pathways, and laboratory testing strategies will be provided. However, the focus of this review is the classic and unique features of MA in blood and bone marrow. Acquired MA is a benign disorder for many, but can be detrimental for some. The clinical presentation can vary considerably, and the spectrum of symptoms and signs is diverse and quite broad. Prompt recognition and therapy are critical to prevent potential irreversible damage and clinical sequelae, especially in patients with vitamin B deficiency. A delay in diagnosis of vitamin B deficiency can result in significant neurologic sequelae that may not fully resolve with treatment, including in neonates and young infants. The blood and bone marrow features in MA can closely mimic thrombocytopenic purpura, myelodysplasia, and other myeloid neoplasms. Both pancytopenia and normal MCV at presentation are common in MA and raise unique challenges for the diagnostician. Partially treated MA is also a significant diagnostic "trap". MA is highly responsive to treatment, and patients tend to improve rapidly upon treatment initiation. However, the broad range of clinical and hematologic features makes the rapid, successful diagnosis of MA a unique challenge for the hematopathologist. Even in the era of state-of-the-art laboratory testing, a high suspicion is required.
Topics: Anemia, Megaloblastic; Folic Acid; Folic Acid Deficiency; Humans; Infant; Infant, Newborn; Vitamin B 12; Vitamin B 12 Deficiency
PubMed: 34981651
DOI: 10.1111/ijlh.13789 -
Expert Review of Endocrinology &... 2023Vitamin D deficiency affects from 10% to 50% in various pediatric population groups and causes life-threatening hypocalcemia in infants, crippling rickets in infants and... (Review)
Review
INTRODUCTION
Vitamin D deficiency affects from 10% to 50% in various pediatric population groups and causes life-threatening hypocalcemia in infants, crippling rickets in infants and children, and increased risk of subsequent adult metabolic and neurologic problems.
AREAS COVERED
An English language literature search of PubMed was performed since 1940 as were the authors' personal literature collections. References identified in the reviewed literature are considered.
DIAGNOSIS
The diagnosis of vitamin D deficiency is based on serum 25-hydroxyvitamin D levels. Clinical features of rickets include bone deformities and elevated alkaline phosphatase. Most children and adolescents who are biochemically vitamin D deficient do not have specific symptoms or signs of deficiency.
PREVENTION
Prevention of vitamin D deficiency is via exposure to sunshine, food and beverage fortification, and dietary supplementation.
TREATMENT
Effective treatment of vitamin D deficiency is via oral or injectable administration of vitamin D. Dosing and duration of vitamin D therapy have been described for healthy children and for children with underlying medical conditions, but recommendations vary.
EXPERT OPINION
Further investigation is needed to determine long-term non-skeletal effects of childhood vitamin D deficiency, benefits of supplementation in asymptomatic individuals with biochemical vitamin D deficiency, and appropriate screening for vitamin D deficiency in asymptomatic children and adolescents.
Topics: Infant; Adolescent; Child; Humans; Vitamin D Deficiency; Rickets; Vitamin D; Hypocalcemia; Treatment Outcome
PubMed: 37861060
DOI: 10.1080/17446651.2023.2270053 -
Fertility and Sterility May 2021
Topics: Humans; Leiomyoma; Vitamin D Deficiency
PubMed: 33743958
DOI: 10.1016/j.fertnstert.2021.02.040 -
Nutrients May 2021Although the symptoms related to vitamin C deficiency were known in ancient Egypt and eighteenth century Scottish surgeon James Lind found that scurvy (a disease...
Although the symptoms related to vitamin C deficiency were known in ancient Egypt and eighteenth century Scottish surgeon James Lind found that scurvy (a disease resulting from insufficient dietary ingestion of vitamin C) could be effectively treated with citrus fruit, this vitamin was discovered only in the year 1912 and then after 21 years it was chemically synthetized and introduced to the market as the first vitamin supplement [...].
Topics: Ascorbic Acid; Ascorbic Acid Deficiency; Citrus; Diet; Dietary Supplements; Humans; Scurvy; Vitamins
PubMed: 34064549
DOI: 10.3390/nu13051595 -
Practical Neurology Mar 2024Strachan's syndrome comprises a triad of optic, auditory and painful sensory peripheral neuropathy. It has been recognised since the late 19th century and is presumed to... (Review)
Review
Strachan's syndrome comprises a triad of optic, auditory and painful sensory peripheral neuropathy. It has been recognised since the late 19th century and is presumed to result from nutritional deficiency. Patients present acute or subacutely after a period of systemic illness, weight loss or, most commonly, dietary restriction, especially veganism, which can cause riboflavin (vitamin B) and vitamin B deficiencies. The syndrome is more common in people who are black British and often of Jamaican descent. We describe the clinical phenotype using a typical case example, review other endemic nutritional peripheral neuropathies and discuss the potential benefit of riboflavin as a treatment.
Topics: Humans; Peripheral Nervous System Diseases; Riboflavin Deficiency; Optic Nerve Diseases; Riboflavin; Vitamins; Vitamin B 12 Deficiency
PubMed: 38290841
DOI: 10.1136/pn-2023-003822 -
Veterinary Medicine and Science Mar 2021The high incidence of disease in captive pangolins is a major obstacle in pangolin-conservation breeding programs. Therefore, elucidating pangolins' susceptibility to...
The high incidence of disease in captive pangolins is a major obstacle in pangolin-conservation breeding programs. Therefore, elucidating pangolins' susceptibility to disease is the key to conservation progress. At the Pangolin Research Base for Artificial Rescue and Conservation Breeding of South China Normal University (PRB-SCNU), vitamin A deficiency was diagnosed in 14 captive Sunda pangolins. Typical eye signs included lacrimal eyes, keratopathy and a blank, milky orb. The afflicted pangolins were treated with vitamins A and D for 15-30 days; all individuals recovered. We report the detection and treatment of vitamin A deficiency in captive Sunda pangolins at the PRB-SCNU. Our results could provide guidance for the future prevention and treatment of vitamin A deficiency and associated diseases in pangolin species, both to reduce the incidence of these diseases in captive pangolins and to aid conservation efforts.
Topics: Animals; Animals, Zoo; China; Conservation of Natural Resources; Pangolins; Vitamin A; Vitamin A Deficiency; Vitamins
PubMed: 33058569
DOI: 10.1002/vms3.367 -
Schizophrenia Research Sep 2022Over the last half century, a body of convergent evidence has accumulated linking disruption of early brain development with an increased risk of mental disorders,... (Review)
Review
Over the last half century, a body of convergent evidence has accumulated linking disruption of early brain development with an increased risk of mental disorders, including schizophrenia. The orderly cascade of brain development may be disrupted by exposure to suboptimal concentrations of a range of biological substrates and micronutrients. We hypothesized that those exposed to vitamin D deficiency during early life, have an increased risk of neurodevelopmental disorders, including schizophrenia. The hypothesis was based on the link between an increased risk of schizophrenia in (a) those born in winter and spring, when vitamin D deficiency is more prevalent, and (b) the offspring of dark-skinned migrants living in cold climates, who have a markedly increased risk of vitamin D deficiency. In this review, we summarize evidence from analytic epidemiology related to this hypothesis. Two case-control studies based on Danish neonatal dried blood spots have found that neonatal vitamin deficiency is associated with an increased risk of schizophrenia. However, recent genetic analyses have also suggested that common variants linked to schizophrenia may lead to lower vitamin D concentrations (possibly mediated via reduced outdoor activity). We summarize limitations of the current evidence and outline suggestions that can guide future research. Based on currently available data, there is insufficient evidence to support public health recommendations related to this topic. However, we cannot reject the hypothesis that the provision of vitamin D supplementation to pregnant women and/or offspring in groups vulnerable to vitamin D deficiency may subsequently reduce the incidence of schizophrenia in the offspring.
Topics: Female; Humans; Infant, Newborn; Micronutrients; Pregnancy; Schizophrenia; Seasons; Vitamin D; Vitamin D Deficiency
PubMed: 34247885
DOI: 10.1016/j.schres.2021.06.004 -
Pediatric Annals Feb 2023Vitamin K is essential for the process of coagulation. In its absence, severe and sometimes fatal bleeding events can occur, especially in newborns. Vitamin K... (Review)
Review
Vitamin K is essential for the process of coagulation. In its absence, severe and sometimes fatal bleeding events can occur, especially in newborns. Vitamin K prophylaxis at birth has been shown to prevent morbidity and mortality associated with vitamin K deficiency bleeding (VKDB) and is recommended by multiple organizations including the American Academy of Pediatrics and the World Health Organization. Pediatricians should feel comfortable explaining the risks and benefits of vitamin K prophylaxis to families and should be equipped to recognize signs of VKDB, especially given increasing rates of parental refusal. This article aims to improve understanding of VKDB, including prevention, early recognition, and treatment. .
Topics: Infant, Newborn; Humans; Child; Vitamin K Deficiency; Vitamin K; Vitamin K Deficiency Bleeding; Hemorrhage
PubMed: 36779880
DOI: 10.3928/19382359-20230102-02