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Quick restoration of vitamin D in children – 10,000 IU per kg loading dose was not enough – Jan 2017

Can Stoss Therapy Be Used in Children with Vitamin D Deficiency or Insufficiency without Rickets?

J Clin Res Pediatr Endocrinol. 2017 Jan 12. doi: 10.4274/jcrpe.3842. [Epub ahead of print]
Koçyiğit C, Çatlı G, İnce G, Özkan EB, Dündar BN.


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OBJECTIVE:
Stoss treatment has also been suggested due to non-skeletal benefits of vitamin D in adults, but no sufficient data are present about the optimal dose of vitamin D replacement in children with vitamin D deficiency/insufficiency without rickets. This study aimed to compare efficiency/side effects of two different stoss therapy regimens (10.000 IU/kg and 300.000 IU vitamin-D3) administered in children with vitamin D deficiency/insufficiency without rickets.

METHODS:
Sixty-four children who had vitamin-D deficiency/insufficiency were studied. A serum level of 25-hydroxyvitamin-D(25-OH-D) 15-20 ng/mL was considered vitamin-D insufficient and <15 ng/mL was considered vitamin-D deficient. Children were divided into two groups according to stoss therapy doses. Serum calcium, phosphate, alkaline phosphatase, 25-OH-D, parathyroid hormone, and spot urine calcium/creatinine ratios before/after treatment were recorded. Wrist radiography and renal ultrasonography were performed.

RESULTS:
The mean age was 10.6±4.4 years. Thirty-two children were treated with a single vitamin-D3 dose of 10.000 IU/kg and 32 patients received 300.000 IU. No difference was found in 25-OH-D levels between the two groups at presentation. The mean level of 25-OH-D was higher in the 10.000 IU/kg group at the second week of therapy. There was no difference between the groups at post-treatment weeks 4 and 12. The 25-OH-D was found below optimal levels(≥30 ng/mL) in 66.5% and <20 ng/mL in 21.8% of patients at the third month in both groups. None developed hypercalcemia and/or hypercalciuria. Nephrolithiasis was not detected in any patients.

CONCLUSION:
This study showed that both doses of stoss therapy used in the treatment of vitamin D insufficiency/deficiency are effective and safe. However, an optimal level of 25-OH-D cannot be maintained for more than three months.

PMID: 28077342 DOI: 10.4274/jcrpe.3842

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7808 Stoss 300,000 children.pdf PDF 2017 admin 06 Mar, 2017 23:43 6.74 Mb 331
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