1.
Complete resolution of sickle cell chronic pain with high dose vitamin D therapy: a case report and review of the literature.
Osunkwo, I
Journal of pediatric hematology/oncology. 2011;(7):549-51
Abstract
With age, individuals with sickle cell disease (SCD) experience daily chronic pain. Vitamin D deficiency (VDD) can result in chronic pain, osteoporosis, fractures, and muscle weakness. Several studies report a high prevalence of VDD in SCD; however, the clinical correlates have not been well described. We describe a case of SCD chronic pain associated with profound VDD, osteoporosis, and osteonecrosis. Treatment with high-dose vitamin D resulted in complete resolution of chronic pain symptoms and improvement in bone density. Randomized studies of vitamin D in SCD may help elucidate its role in the management of chronic pain and bone disease.
2.
The potential to improve diabetes control with vitamin D replacement in African American patients: case report and literature review.
Youssef, D, El Abbassi, A, Jones, K, Woodby, G, Peiris, A
Tennessee medicine : journal of the Tennessee Medical Association. 2010;(4):35-6
Abstract
African Americans have a higher prevalence of Diabetes mellitus and associated complications. The prevalence of Vitamin D deficiency is also higher in African Americans. We report an African American veteran who was followed for a period of 10 years in the Endocrine clinic for insulin-requiring diabetes. Despite intensive, medical, nutritional and educational efforts during that period, no discernible progress was made in achieving any improvement in glycemic control. The patient appeared to be noncompliant with recommended strategies to improve glycemia. The patient was seen recently and was found to be profoundly Vitamin D deficient with a 25 (OH) Vitamin D level of 11.6 ng/ml [30-100 ng/ml]. While patient did not wish to change his insulin regimen or diabetic management, he was willing to accept Vitamin D therapy. Replacement with Vitamin D was associated with significant improvement in glycosylated hemoglobin to previously unmatched levels of glycemic control. We discuss the multiple potential mechanisms by which improved Vitamin D status may result in improved diabetes control. Given the current pandemic of Vitamin D deficiency and the plethora of potential benefits, we recommend maintaining adequate Vitamin D reserves in diabetic patients with a special emphasis on minority populations.
3.
Treatable lower motor neuron disease due to vitamin D deficiency and secondary hyperparathyroidism.
Whitaker, CH, Malchoff, CD, Felice, KJ
Amyotrophic lateral sclerosis and other motor neuron disorders : official publication of the World Federation of Neurology, Research Group on Motor Neuron Diseases. 2000;(4):283-6
Abstract
Vitamin D deficiency and osteomalacia are frequently associated with muscle weakness and atrophy. We present a 78-year-old man with complaints of progressive painless weakness who was referred to us with a diagnosis of suspected motor neuron disease. Results of the neurological examination were remarkable, showing diffuse limb weakness and atrophy, rare fasciculations, normal sensory examination, no bulbar weakness, and no upper motor neuron signs. Electromyography revealed mild chronic changes, denervation and re-innervation, without fibrillations or positive waves. Serum laboratory studies showed an elevated serum parathyroid hormone and markedly reduced vitamin D level. Although the etiology of the vitamin D deficiency was not determined, the patient made a substantial clinical improvement following vitamin D therapy. Vitamin D deficiency and secondary hyperparathyroidism need to be included in the differential diagnosis of patients presenting with a progressive lower motor neuron disease.