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LETTER TO THE EDITOR
Year : 2015  |  Volume : 19  |  Issue : 1  |  Page : 188

Seizure as a presenting manifestation of vitamin D dependent rickets type 1


Department of Paediatrics, Al Kindy College of Medicine, Baghdad University, Baghdad, Iraq

Date of Web Publication12-Dec-2014

Correspondence Address:
Mahmood Dhahir Al-Mendalawi
P O Box - 55302, Baghdad
Iraq
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-8210.131772

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How to cite this article:
Al-Mendalawi MD. Seizure as a presenting manifestation of vitamin D dependent rickets type 1. Indian J Endocr Metab 2015;19:188

How to cite this URL:
Al-Mendalawi MD. Seizure as a presenting manifestation of vitamin D dependent rickets type 1. Indian J Endocr Metab [serial online] 2015 [cited 2019 Nov 14];19:188. Available from: http://www.ijem.in/text.asp?2015/19/1/188/131772

Sir,

With reference to the interesting case report by Rani et al., [1] vitamin D dependent rickets type 1 (VDDR-I) has been increasingly reported in the Indian subcontinent. [2] Apart from the suggestive clinical picture of rickets, hypotonia, muscle weakness, growth failure, and hypocalcemic seizures in early infancy, certain characteristic laboratory features of increased serum concentrations of parathyroid hormone, and low or undetectable serum concentrations of 1,25-dihydroxyvitamin D (1,25(OH) 2D) despite normal or increased concentrations of 25-hydroxyvitamin D (25-OHD) in addition to genetic mutational studies, must be sought to confirm the diagnosis of VDDR-I. [3],[4] I realize that such confirmation was not feasible in the studied patient by Rani et al.[1] in the view of financial constraints and lack of availability. It is wellknown that nutritional rickets is a major public health problem in many parts of the world, particularly developing countries. Even in the Indian context, it has been reported to be present in the majority of children in spite of the wide availability of sunlight. [5] I presume that Rani et al., [1] through their case report, sent a sound message to pediatricians in developing countries with limited financial resources to consider therapeutic trial of 1 α calciferol in children with rickets who fail to respond to conventional doses of cholecalciferol combined with calcium supplements before referring them to pediatric endocrinologists to exclude hereditary-related rickets.

 
   References Top

1.
Rani PR, Maheshwari R, Prasad NR, Karthik Reddy TS, Reddy PA. Seizure as a presenting manifestation of vitamin D dependent rickets type 1. Indian J Endocrinol Metab 2013;17:S665-6.  Back to cited text no. 1
    
2.
Zargar AH, Mithal A, Wani AI, Laway BA, Masoodi SR, Bashir MI, et al. Pseudovitamin D deficiency rickets: A report from the Indian subcontinent. Postgrad Med J 2000;76:369-72.  Back to cited text no. 2
    
3.
Kim CJ. Vitamin D dependent rickets type I. Korean J Pediatr 2011;54:51-4.  Back to cited text no. 3
    
4.
Malloy PJ, Feldman D. Genetic disorders and defects in vitamin d action. Endocrinol Metab Clin North Am 2010;39:333-46.  Back to cited text no. 4
    
5.
Balasubramanian S, Dhanalakshmi K, Amperayani S. Vitamin d deficiency in childhood: A review of current guidelines on diagnosis and management. Indian Pediatr 2013;50:669-75.  Back to cited text no. 5
    




 

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