Document Detail


Vitamin D--deficient rickets in a child with cow's milk allergy.
MedLine Citation:
PMID:  20702845     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This article describes the case of a 16-month-old Hispanic male toddler with cow's milk allergy living in northern California who was admitted to a children's hospital for weight loss and markedly elevated levels of serum alkaline phosphatase and parathyroid hormone. At a routine outpatient well-child visit, his mother expressed concern about a decrease in his appetite and activity level. A detailed diet history revealed that breast milk was his primary source of nutrition during his first year of life and he had not been given supplemental vitamins. With attempts to introduce cow's milk formula, he had developed a rash and swelling around the mouth. Shortly after his first birthday, his mother weaned him from breast milk and introduced unfortified rice milk as a palatable milk substitute. Upon admission he was pale and lethargic; his laboratory studies were remarkable for elevated serum alkaline phosphatase and parathyroid hormone and low levels of phosphorus, 25-hydroxy-vitamin D, and ferritin. Lower extremity radiographic studies were consistent with rickets. After 5 weeks of therapy with vitamin D(3) and iron, his serum 25-hydroxy-vitamin D level normalized. Within 12 weeks following therapy, the child demonstrated significant clinical improvement, with resolution of growth failure and bone reossification. His activity level had returned to normal. This case emphasizes the importance of adequate vitamin D intake for children with special attention to those who might have nutrition deficiencies attributable to milk allergy.
Authors:
Odmara L Barreto-Chang; Odmara Barreto-Chang; Doriel Pearson; W Elizabeth Shepard; Christopher A Longhurst; Chris Longhurst; Alan Greene
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition     Volume:  25     ISSN:  1941-2452     ISO Abbreviation:  Nutr Clin Pract     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-12     Completed Date:  2011-02-17     Revised Date:  2011-05-13    
Medline Journal Info:
Nlm Unique ID:  8606733     Medline TA:  Nutr Clin Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  394-8     Citation Subset:  IM; N    
Affiliation:
Division of General Pediatrics, Lucile Packard Children's Hospital, Stanford University School of Medicine, Palo Alto, California, USA. [corrected]
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MeSH Terms
Descriptor/Qualifier:
Animals
Cattle
Humans
Infant
Iron, Dietary / therapeutic use
Male
Micronutrients / therapeutic use
Milk Hypersensitivity / complications*
Rickets / blood,  drug therapy,  etiology*
Vitamin D / analogs & derivatives*,  blood,  therapeutic use*
Vitamins / therapeutic use*
Chemical
Reg. No./Substance:
0/Iron, Dietary; 0/Micronutrients; 0/Vitamins; 1406-16-2/Vitamin D; 64719-49-9/25-hydroxyvitamin D
Comments/Corrections
Erratum In:
Nutr Clin Pract. 2011 Apr;26(2):208
Note: Barreto-Chang, Odmara [corrected to Barreto-Chang, Odmara L]; Longhurst, Chris [corrected to Longhurst, Christopher A]

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