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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2010 October;169(5):261-7
A case of severe hypovitaminosis D in an immigrant adolescent girl
Cremaschini G., Sassi G., Tedoldi S., Corna A., Vaccaro T, Cipolletta E., Santella L., Tramaloni G., Cappellaro E., Colombo M.
Pediatrics Manerbio Hospital, Manerbio, Brescia, Italia
Rickets attributable to vitamin D deficiency is a condition that is preventable with adequate nutritional intake of vitamin D; however, it is still a public health problem worldwide and new cases continue to be reported in the United States and other Western countries, especially in exclusively breastfed infants and in dark-skinned children. Vitamin D deficiency is not limited to infancy and early childhood but covers the life span, particularly periods of accelerated growth. In fact new cases continue to be reported in older children and adolescents. In these patients the diagnosis is difficult and can be delayed because the clinical presentation is insidious and there aren’t the typical rickets signs such as in children. We present a case report on an immigrant adolescent girl who was admitted to the hospital because of progressive asthenia, weakness and nonspecific musculoskeletal pain associated with serious distal muscular hypotrophy in legs. Unexpectedly it showed itself to be a severe hypovitaminosis D with consequent hypocalcemia. This hypovitaminosis must be considered and not underestimate, not in the childood only but also in those periods of rapid bone growth and comportamental development such as adolescence. In addition to musculoskeletal complications, vitamin D deficiency may be involved in the pathophysiology of many chronic disease (immune system alterations and reduced resistance to infections, asthma, type 1 diabetes, multiple sclerosis, obesity, cardiovascular disease and cancer). The role of pediatricians is of primary importance: to identify, to investigate and to treat possible hypovitaminosis D states, often misdiagnosticated.