婴儿低钙性癫痫发作及其与母体维生素D缺乏的关系

R. Biswas, Abm Kamrul Hasan
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摘要

背景:低钙血症是我院急诊科大量婴儿癫痫发作的原因。目的:探讨维生素D缺乏在婴儿期低钙性癫痫发病中的作用及其与母体维生素D水平的关系。方法:2016年7月至2019年6月,以横断面医院为基础,为期35个月。共有60名患有低钙癫痫发作的婴儿参加了这项研究。采集患儿血清总钙、无机磷酸盐、碱性磷酸酶、白蛋白、25(OH)D、甲状旁腺激素。同时测定母体血清25(OH)D水平。结果:研究婴儿的平均年龄为3.6(±1.2)个月。所有患者均有低总钙(平均6.5 mg/dl)和低无机磷酸盐(平均3.5 mg/dl),而所有患者在就诊时碱性磷酸酶(平均1093.50 IU/L)和甲状肾上腺素(平均104 pg/ml)水平升高。40%的婴儿严重缺乏维生素D, 60%缺乏维生素D;都没有足够的维生素D新生儿25(OH)D与新生儿血清PTH水平呈显著负相关,与母亲血清25(OH)D水平呈显著正相关,新生儿25(OH)D与母亲血清25(OH)D水平呈显著正相关。结论:本组患儿发生的低钙性癫痫均为维生素D缺乏所致,且多与母体维生素D缺乏有关。DS(儿童)H J 2021;37 (2): 98 - 102
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Hypocalcemic Seizures in Infancy and its Relationship with Maternal Vitamin D Deficiency
Background: Hypocalcemia accounts for a large number of seizures in infants presented at the emergency department of our hospital. Objective: To evaluate the role of Vitamin D deficiency as the etiology of hypocalcemic seizures in infancy and its relationship with maternal Vitamin D levels. Methods: Cross sectional hospital based study over a period of 35 months from July 2016 to June 2019. Total 60 infants with hypocalcemic seizures were enrolled into the study. Blood samples were taken for serum total calcium, inorganic phosphate, alkaline phosphatase, albumin, 25(OH)D and PTH from the child. Maternal serum 25(OH)D levels were measured as well. Results: The mean age of the studied infants was 3.6 (±1.2) months. All patients had low total calcium (mean 6.5 mg/dl) and most of them had low inorganic phosphate (mean 3.5 mg/dl), while all of them had raised alkaline phosphatase (mean 1093.50 IU/L) and PTH levels (mean104 pg/ml) at presentation. Forty percent of infants were severely deficient and 60% were deficient in vitamin D; none of them were vitamin D sufficient. Among their mothers, none were sufficient, 10% were insufficient, 45% were deficient, and 45% were severe deficient of vitamin D. Neonatal 25(OH)D showed strong negative correlation with their serum PTH levels and strong positive correlations with maternal serum 25(OH)D levels. Conclusion: All infants in our setting presented with hypocalcemic seizures were found due to Vitamin D deficiency and it was mostly related to maternal Vitamin D deficiency. DS (Child) H J 2021; 37(2): 98-102
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