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==Medical therapy== | ==Medical therapy== | ||
There are | There are two major forms of vitamin D; ergocalciferol (vitamin D2), cholecalciferol (vitamin D3). A systematic review and meta-analysis of Tripkovic L et al. in 2011, indicated that vitamin D3 compared to vitamin D2 is more effective to raise the serum level of 25OHD and is preferred for treatment and prevention. <ref name="TripkovicLambert2012">{{cite journal|last1=Tripkovic|first1=L.|last2=Lambert|first2=H.|last3=Hart|first3=K.|last4=Smith|first4=C. P.|last5=Bucca|first5=G.|last6=Penson|first6=S.|last7=Chope|first7=G.|last8=Hypponen|first8=E.|last9=Berry|first9=J.|last10=Vieth|first10=R.|last11=Lanham-New|first11=S.|title=Comparison of vitamin D2 and vitamin D3 supplementation in raising serum 25-hydroxyvitamin D status: a systematic review and meta-analysis|journal=American Journal of Clinical Nutrition|volume=95|issue=6|year=2012|pages=1357–1364|issn=0002-9165|doi=10.3945/ajcn.111.031070}}</ref> | ||
AAP recommends an initial phase of treatment with high dose of [[vitamin D]] for 2-3 months to treat vitamin D deficiency rickets. The recommended dose is 1000 IU/d in neonates, 1000-5000 IU/d in infants, and 5000 IU/d for children over 1-year-old. <ref name="LeeSo2013">{{cite journal|last1=Lee|first1=Ji Yeon|last2=So|first2=Tsz-Yin|last3=Thackray|first3=Jennifer|title=A Review on Vitamin D Deficiency Treatment in Pediatric Patients|journal=The Journal of Pediatric Pharmacology and Therapeutics|volume=18|issue=4|year=2013|pages=277–291|issn=1551-6776|doi=10.5863/1551-6776-18.4.277}}</ref> | The American Academy of Pediatrics (AAP) recommends an initial phase of treatment with high dose of [[vitamin D]] for 2-3 months to treat vitamin D deficiency rickets. The recommended dose is 1000 IU/d in neonates, 1000-5000 IU/d in infants, and 5000 IU/d for children over 1-year-old. <ref name="LeeSo2013">{{cite journal|last1=Lee|first1=Ji Yeon|last2=So|first2=Tsz-Yin|last3=Thackray|first3=Jennifer|title=A Review on Vitamin D Deficiency Treatment in Pediatric Patients|journal=The Journal of Pediatric Pharmacology and Therapeutics|volume=18|issue=4|year=2013|pages=277–291|issn=1551-6776|doi=10.5863/1551-6776-18.4.277}}</ref> | ||
After raising the serum 25 OHD levels to …., a maintenance dose of 400 IU/d is required for all age groups. Higher maintenance dose (800 IU/d) might be needed in at risk groups. <ref name="pmid18676559">{{cite journal |vauthors=Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M |title=Vitamin D deficiency in children and its management: review of current knowledge and recommendations |journal=Pediatrics |volume=122 |issue=2 |pages=398–417 |year=2008 |pmid=18676559 |doi=10.1542/peds.2007-1894 |url=}}</ref> | After raising the serum 25 OHD levels to …., a maintenance dose of 400 IU/d is required for all age groups. Higher maintenance dose (800 IU/d) might be needed in at risk groups. <ref name="pmid18676559">{{cite journal |vauthors=Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M |title=Vitamin D deficiency in children and its management: review of current knowledge and recommendations |journal=Pediatrics |volume=122 |issue=2 |pages=398–417 |year=2008 |pmid=18676559 |doi=10.1542/peds.2007-1894 |url=}}</ref> | ||
Revision as of 02:24, 1 September 2017
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Vitamin D deficiency Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]
Overview
The mainstay of therapy for vitamin D deficiency is vitamin D.
Medical therapy
There are two major forms of vitamin D; ergocalciferol (vitamin D2), cholecalciferol (vitamin D3). A systematic review and meta-analysis of Tripkovic L et al. in 2011, indicated that vitamin D3 compared to vitamin D2 is more effective to raise the serum level of 25OHD and is preferred for treatment and prevention. [1]
The American Academy of Pediatrics (AAP) recommends an initial phase of treatment with high dose of vitamin D for 2-3 months to treat vitamin D deficiency rickets. The recommended dose is 1000 IU/d in neonates, 1000-5000 IU/d in infants, and 5000 IU/d for children over 1-year-old. [2] After raising the serum 25 OHD levels to …., a maintenance dose of 400 IU/d is required for all age groups. Higher maintenance dose (800 IU/d) might be needed in at risk groups. [3]
An alternative strategy for treatment, also known as stoss therapy, is a single dose therapy in patients over 1-month-old. 100,000 – 600,000 IU of ergocalciferol orally single dose followed by maintenance therapy is recommended, especially in noncompliant patients. [4]
Special circumstances
- Patients on anticonvulsant drugs are at risk of vitamin D deficiency. If osteopenia occurs, treatment with 2000-4000 IU/d must be started. In case of osteomalacia, a larger dose of vitamin D, 5000-15000 IU/d is required. [5]
References
- ↑ Tripkovic, L.; Lambert, H.; Hart, K.; Smith, C. P.; Bucca, G.; Penson, S.; Chope, G.; Hypponen, E.; Berry, J.; Vieth, R.; Lanham-New, S. (2012). "Comparison of vitamin D2 and vitamin D3 supplementation in raising serum 25-hydroxyvitamin D status: a systematic review and meta-analysis". American Journal of Clinical Nutrition. 95 (6): 1357–1364. doi:10.3945/ajcn.111.031070. ISSN 0002-9165.
- ↑ Lee, Ji Yeon; So, Tsz-Yin; Thackray, Jennifer (2013). "A Review on Vitamin D Deficiency Treatment in Pediatric Patients". The Journal of Pediatric Pharmacology and Therapeutics. 18 (4): 277–291. doi:10.5863/1551-6776-18.4.277. ISSN 1551-6776.
- ↑ Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M (2008). "Vitamin D deficiency in children and its management: review of current knowledge and recommendations". Pediatrics. 122 (2): 398–417. doi:10.1542/peds.2007-1894. PMID 18676559.
- ↑ Shah BR, Finberg L (1994). "Single-day therapy for nutritional vitamin D-deficiency rickets: a preferred method". J. Pediatr. 125 (3): 487–90. PMID 8071764.
- ↑ Drezner MK (2004). "Treatment of anticonvulsant drug-induced bone disease". Epilepsy Behav. 5 Suppl 2: S41–7. doi:10.1016/j.yebeh.2003.11.028. PMID 15123011.