Advertisement
Advances in Pediatrics

Detecting Disorders of Vitamin D Deficiency in Children

An Update
  • Pallavi Iyer
    Correspondence
    Corresponding author.
    Affiliations
    Division of Endocrinology & Diabetes, All Children’s Specialty Physicians, All Children’s Hospital/Johns Hopkins Medicine, 601 5th Street South, Dept 7854, St Petersburg, FL 33701, USA
    Search for articles by this author
  • Frank Diamond
    Affiliations
    Division of Endocrinology & Diabetes, All Children’s Specialty Physicians, All Children’s Hospital/Johns Hopkins Medicine, 601 5th Street South, Dept 7854, St Petersburg, FL 33701, USA
    Search for articles by this author
      Rickets caused by vitamin D deficiency is still of clinical importance, especially in certain high-risk children.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Advances in Pediatrics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Harrison H.E.
        A tribute to the first lady of public health (Martha M. Eliot). V. The disappearance of rickets.
        Am J Public Health Nations Health. 1966; 56: 734-737
        • Armas L.A.
        • Hollis B.W.
        • Heaney R.P.
        Vitamin D2 is much less effective than vitamin D3 in humans.
        J Clin Endocrinol Metab. 2004; 89: 5387-5391
        • Holick M.F.
        Vitamin D: evolutionary, physiological and health perspectives.
        Curr Drug Targets. 2011; 12: 4-18
        • Autier P.
        • Gandini S.
        • Mullie P.
        A systematic review: influence of vitamin D supplementation on serum 25-hydroxyvitamin D concentration.
        J Clin Endocrinol Metab. 2012; 97: 2606-2613
        • Norris J.M.
        Can the sunshine vitamin shed light on type 1 diabetes?.
        Lancet. 2001; 358: 1476-1478
        • Fraser D.R.
        Vitamin D.
        Lancet. 1995; 345: 104-107
        • Schuster I.
        Cytochromes P450 are essential players in the vitamin D signaling system.
        Biochim Biophys Acta. 2011; 1814: 186-199
        • Oliveira R.B.
        • Moyses R.M.
        FGF-23: state of the art.
        J Bras Nefrol. 2010; 32: 323-331
        • Misra M.
        • Pacaud D.
        • Petryk A.
        • et al.
        Vitamin D deficiency in children and its management: review of current knowledge and recommendations.
        Pediatrics. 2008; 122: 398-417
        • Kovacs C.S.
        Vitamin D in pregnancy and lactation: maternal, fetal, and neonatal outcomes from human and animal studies.
        Am J Clin Nutr. 2008; 88: 520S-528S
        • Holick M.F.
        Resurrection of vitamin D deficiency and rickets.
        J Clin Invest. 2006; 116: 2062-2072
        • Root A.W.
        Disorders of mineral metabolism.
        in: Sperling M.A. Pediatric endocrinology. 4th edition. Elsevier, Philadelphia2013 ([In press])
        • Weisman Y.
        Maternal, fetal and neonatal vitamin D and calcium metabolism during pregnancy and lactation.
        Endocr Dev. 2003; 6: 34-49
        • Baiz N.
        • Dargent-Molina P.
        • Wark J.D.
        • et al.
        Gestational exposure to urban air pollution related to a decrease in cord blood vitamin d levels.
        J Clin Endocrinol Metab. 2012; 97: 4087-4095
        • Holick M.F.
        Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease.
        Am J Clin Nutr. 2004; 80: 1678S-1688S
        • Saintonge S.
        • Bang H.
        • Gerber L.M.
        Implications of a new definition of vitamin D deficiency in a multiracial us adolescent population: the National Health and Nutrition Examination Survey III.
        Pediatrics. 2009; 123: 797-803
        • Mansbach J.M.
        • Ginde A.A.
        • Camargo Jr., C.A.
        Serum 25-hydroxyvitamin D levels among US children aged 1 to 11 years: do children need more vitamin D?.
        Pediatrics. 2009; 124: 1404-1410
        • Holick M.F.
        • Krane S.M.
        • Potts J.T.
        Calcium, phosphorus and bone metabolism: calcium-regulation hormones.
        in: Fauci A.S. Baunwald E. Isselbacher K.J. Harrison's principles of internal medicine. McGraw-Hill, New York1995: 2214
        • Pitt M.J.
        Rickets and osteomalacia are still around.
        Radiol Clin North Am. 1991; 29: 97-118
        • Sonneville K.R.
        • Gordon C.M.
        • Kocher M.S.
        • et al.
        Vitamin D, calcium, and dairy intakes and stress fractures among female adolescents.
        Arch Pediatr Adolesc Med. 2012; 166: 595-600
        • Chapman T.
        • Sugar N.
        • Done S.
        • et al.
        Fractures in infants and toddlers with rickets.
        Pediatr Radiol. 2010; 40: 1184-1189
        • Hill K.M.
        • McCabe G.P.
        • McCabe L.D.
        • et al.
        An inflection point of serum 25-hydroxyvitamin D for maximal suppression of parathyroid hormone is not evident from multi-site pooled data in children and adolescents.
        J Nutr. 2010; 140: 1983-1988
        • Spence J.T.
        • Serwint J.R.
        Secondary prevention of vitamin D-deficiency rickets.
        Pediatrics. 2004; 113: e70-e72
        • Rosen C.J.
        • Abrams S.A.
        • Aloia J.F.
        • et al.
        IOM committee members respond to Endocrine Society vitamin D guideline.
        J Clin Endocrinol Metab. 2012; 97: 1146-1152
        • Ross A.C.
        • Manson J.E.
        • Abrams S.A.
        • et al.
        The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know.
        J Clin Endocrinol Metab. 2011; 96: 53-58
        • Hollis B.W.
        Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D.
        J Nutr. 2005; 135: 317-322
        • Holick M.F.
        • Binkley N.C.
        • Bischoff-Ferrari H.A.
        • et al.
        Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline.
        J Clin Endocrinol Metab. 2011; 96: 1911-1930
        • Barake M.
        • Daher R.T.
        • Salti I.
        • et al.
        25-hydroxyvitamin D assay variations and impact on clinical decision making.
        J Clin Endocrinol Metab. 2012; 97: 835-843
        • de la Hunty A.
        • Wallace A.M.
        • Gibson S.
        • et al.
        UK Food Standards Agency Workshop Consensus Report: the choice of method for measuring 25-hydroxyvitamin D to estimate vitamin D status for the UK National Diet and Nutrition Survey.
        Br J Nutr. 2010; 104: 612-619
        • Tsang R.C.
        • Zlotkin S.H.
        • Nichols B.L.
        • et al.
        Nutrition during infancy: principles and practice.
        2nd edition. Digital Education Publishing, Cincinnati (OH)1997
        • Henderson A.
        Vitamin D and the breastfed infant.
        J Obstet Gynecol Neonatal Nurs. 2005; 34: 367-372
        • Sowers M.
        • Eyre D.
        • Hollis B.W.
        • et al.
        Biochemical markers of bone turnover in lactating and nonlactating postpartum women.
        J Clin Endocrinol Metab. 1995; 80: 2210-2216
        • Basile L.A.
        • Taylor S.N.
        • Wagner C.L.
        • et al.
        The effect of high-dose vitamin D supplementation on serum vitamin D levels and milk calcium concentration in lactating women and their infants.
        Breastfeed Med. 2006; 1: 27-35
        • Williamson S.
        • Greene S.
        Rickets: prevention message is not getting through.
        BMJ. 2007; 334: 1288
        • Wharton B.
        • Bishop N.
        Rickets.
        Lancet. 2003; 362: 1389-1400
        • Specker B.L.
        • Valanis B.
        • Hertzberg V.
        • et al.
        Sunshine exposure and serum 25-hydroxyvitamin D concentrations in exclusively breast-fed infants.
        J Pediatr. 1985; 107: 372-376
      1. Ultraviolet light: a hazard to children. American Academy of Pediatrics. Committee on Environmental Health.
        Pediatrics. 1999; 104: 328-333
        • Shah B.R.
        • Finberg L.
        Single-day therapy for nutritional vitamin D-deficiency rickets: a preferred method.
        J Pediatr. 1994; 125: 487-490
        • Schlingmann K.P.
        • Kaufmann M.
        • Weber S.
        • et al.
        Mutations in CYP24A1 and idiopathic infantile hypercalcemia.
        N Engl J Med. 2011; 365: 410-421
        • Wang J.T.
        • Lin C.J.
        • Burridge S.M.
        • et al.
        Genetics of vitamin D 1alpha-hydroxylase deficiency in 17 families.
        Am J Hum Genet. 1998; 63: 1694-1702
        • Edouard T.
        • Alos N.
        • Chabot G.
        • et al.
        Short- and long-term outcome of patients with pseudo-vitamin D deficiency rickets treated with calcitriol.
        J Clin Endocrinol Metab. 2011; 96: 82-89
        • Malloy P.J.
        • Feldman D.
        Genetic disorders and defects in vitamin d action.
        Endocrinol Metab Clin North Am. 2010; 39 (Table of contents): 333-346
        • Brooks M.H.
        • Bell N.H.
        • Love L.
        • et al.
        Vitamin-D-dependent rickets type II. Resistance of target organs to 1,25-dihydroxyvitamin D.
        N Engl J Med. 1978; 298: 996-999
        • Ma N.S.
        • Malloy P.J.
        • Pitukcheewanont P.
        • et al.
        Hereditary vitamin D resistant rickets: identification of a novel splice site mutation in the vitamin D receptor gene and successful treatment with oral calcium therapy.
        Bone. 2009; 45: 743-746
        • Hirst M.A.
        • Hochman H.I.
        • Feldman D.
        Vitamin D resistance and alopecia: a kindred with normal 1,25-dihydroxyvitamin D binding, but decreased receptor affinity for deoxyribonucleic acid.
        J Clin Endocrinol Metab. 1985; 60: 490-495
        • Panda D.K.
        • Miao D.
        • Bolivar I.
        • et al.
        Inactivation of the 25-hydroxyvitamin D 1alpha-hydroxylase and vitamin D receptor demonstrates independent and interdependent effects of calcium and vitamin D on skeletal and mineral homeostasis.
        J Biol Chem. 2004; 279: 16754-16766
        • Liu P.T.
        • Stenger S.
        • Li H.
        • et al.
        Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response.
        Science. 2006; 311: 1770-1773
        • Bikle D.
        Nonclassic actions of vitamin D.
        J Clin Endocrinol Metab. 2009; 94: 26-34
        • Bikle D.D.
        Vitamin D and immune function: understanding common pathways.
        Curr Osteoporos Rep. 2009; 7: 58-63
        • Rosen C.J.
        • Adams J.S.
        • Bikle D.D.
        • et al.
        The nonskeletal effects of vitamin D: an Endocrine Society scientific statement.
        Endocr Rev. 2012; 33: 456-492
        • Bland R.
        • Markovic D.
        • Hills C.E.
        • et al.
        Expression of 25-hydroxyvitamin D3-1alpha-hydroxylase in pancreatic islets.
        J Steroid Biochem Mol Biol. 2004; 89–90: 121-125
        • Wolden-Kirk H.
        • Overbergh L.
        • Gysemans C.
        • et al.
        Unraveling the effects of 1,25(OH)(2)D(3) on global gene expression in pancreatic islets.
        J Steroid Biochem Mol Biol. 2012; ([Epub ahead of print])
        • Gupta R.
        • Dixon K.M.
        • Deo S.S.
        • et al.
        Photoprotection by 1,25 dihydroxyvitamin D3 is associated with an increase in p53 and a decrease in nitric oxide products.
        J Invest Dermatol. 2007; 127: 707-715
        • Rovner A.J.
        • Stallings V.A.
        • Kawchak D.A.
        • et al.
        High risk of vitamin D deficiency in children with sickle cell disease.
        J Am Diet Assoc. 2008; 108: 1512-1516
        • Osunkwo I.
        Complete resolution of sickle cell chronic pain with high dose vitamin D therapy: a case report and review of the literature.
        J Pediatr Hematol Oncol. 2011; 33: 549-551
        • Osunkwo I.
        • Ziegler T.R.
        • Alvarez J.
        • et al.
        High dose vitamin D therapy for chronic pain in children and adolescents with sickle cell disease: results of a randomized double blind pilot study.
        Br J Haematol. 2012; 159: 211-215
        • Mathieu C.
        • Waer M.
        • Laureys J.
        • et al.
        Prevention of autoimmune diabetes in NOD mice by 1,25 dihydroxyvitamin D3.
        Diabetologia. 1994; 37: 552-558
        • Hypponen E.
        • Laara E.
        • Reunanen A.
        • et al.
        Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study.
        Lancet. 2001; 358: 1500-1503
        • Stene L.C.
        • Joner G.
        Use of cod liver oil during the first year of life is associated with lower risk of childhood-onset type 1 diabetes: a large, population-based, case-control study.
        Am J Clin Nutr. 2003; 78: 1128-1134
        • Bener A.
        • Alsaied A.
        • Al-Ali M.
        • et al.
        High prevalence of vitamin D deficiency in type 1 diabetes mellitus and healthy children.
        Acta Diabetol. 2009; 46: 183-189
        • Bin-Abbas B.S.
        • Jabari M.A.
        • Issa S.D.
        • et al.
        Vitamin D levels in Saudi children with type 1 diabetes.
        Saudi Med J. 2011; 32: 589-592
        • Greer R.M.
        • Portelli S.L.
        • Hung B.S.
        • et al.
        Serum vitamin D levels are lower in Australian children and adolescents with type 1 diabetes than in children without diabetes.
        Pediatr Diabetes. 2013; 14: 31-41
        • Mutlu A.
        • Mutlu G.Y.
        • Ozsu E.
        • et al.
        Vitamin D deficiency in children and adolescents with type 1 diabetes.
        J Clin Res Pediatr Endocrinol. 2011; 3: 179-183
        • Simpson M.
        • Brady H.
        • Yin X.
        • et al.
        No association of vitamin D intake or 25-hydroxyvitamin D levels in childhood with risk of islet autoimmunity and type 1 diabetes: the Diabetes Autoimmunity Study in the Young (DAISY).
        Diabetologia. 2011; 54: 2779-2788
        • Gabbay M.A.
        • Sato M.N.
        • Finazzo C.
        • et al.
        Effect of cholecalciferol as adjunctive therapy with insulin on protective immunologic profile and decline of residual beta-cell function in new-onset type 1 diabetes mellitus.
        Arch Pediatr Adolesc Med. 2012; 166: 601-607
        • Pappa H.M.
        • Gordon C.M.
        • Saslowsky T.M.
        • et al.
        Vitamin D status in children and young adults with inflammatory bowel disease.
        Pediatrics. 2006; 118: 1950-1961
        • Levin A.D.
        • Wadhera V.
        • Leach S.T.
        • et al.
        Vitamin D deficiency in children with inflammatory bowel disease.
        Dig Dis Sci. 2011; 56: 830-836
        • El-Matary W.
        • Sikora S.
        • Spady D.
        Bone mineral density, vitamin D, and disease activity in children newly diagnosed with inflammatory bowel disease.
        Dig Dis Sci. 2011; 56: 825-829
        • Pappa H.
        • Thayu M.
        • Sylvester F.
        • et al.
        Skeletal health of children and adolescents with inflammatory bowel disease.
        J Pediatr Gastroenterol Nutr. 2011; 53: 11-25
        • Hall W.B.
        • Sparks A.A.
        • Aris R.M.
        Vitamin d deficiency in cystic fibrosis.
        Int J Endocrinol. 2010; 2010: 218691
        • Rovner A.J.
        • Zemel B.S.
        • Leonard M.B.
        • et al.
        Mild to moderate cystic fibrosis is not associated with increased fracture risk in children and adolescents.
        J Pediatr. 2005; 147: 327-331
        • Tangpricha V.
        • Kelly A.
        • Stephenson A.
        • et al.
        An update on the screening, diagnosis, management, and treatment of vitamin D deficiency in individuals with cystic fibrosis: evidence-based recommendations from the Cystic Fibrosis Foundation.
        J Clin Endocrinol Metab. 2012; 97: 1082-1093
        • Shepherd D.
        • Belessis Y.
        • Katz T.
        • et al.
        Single high-dose oral vitamin D(3) (stoss) therapy - a solution to vitamin D deficiency in children with cystic fibrosis?.
        J Cyst Fibros. 2012; 12: 177-182
        • Modan-Moses D.
        • Pinhas-Hamiel O.
        • Munitz-Shenkar D.
        • et al.
        Vitamin D status in pediatric patients with a history of malignancy.
        Pediatr Res. 2012; 72: 620-624
        • Rosen G.P.
        • Beebe K.L.
        • Shaibi G.Q.
        Vitamin D levels differ by cancer diagnosis and decline over time in survivors of childhood cancer.
        Pediatr Blood Cancer. 2013; 60: 949-952