Grand rounds and Teaching Files - Pediatric Oncall
Nutritional Hypovitaminosis D Presenting as Tetany in an Infant

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Clinical Problem:

Ira Shah
Medical Sciences Department, Pediatric Oncall, Mumbai, India

Address for Correspondence: Dr Ira Shah, 1, B Saguna, 271, B St Francis Road, Vile Parle {w}, Mumbai 400056, India.

A 12 months-old boy presented with vomiting, diarrhoea and carpopedal spasm. He was exclusively breast-fed till 6 months of age and was on full diet now. On examination, he had fronto-parietal bossing. There were no other signs of rickets. Other systems were normal. Investigations showed serum calcium 6.5 mg, dl {normal=8.5-11 mg, dl}, with ionic calcium of 0.65 mmol, L {normal =1.1- 1.3 mmol, L}, phosphorus of 4.9 mg, dl and alkaline phosphatase of 1067 IU, L. 25-OH vitamin D3 was 5.0 ng, ml. The patient was treated with IV and oral calcium and vitamin D, to which he responded.

How common is carpopedal spasm in vitamin D deficient infants_? How to treat it_?

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