Abstract
Aims: The aims of this study were to document the incidence of hypocalcaemic cardiomyopathy and to highlight its association with vitamin D deficiency.
Methods: A retrospective chart review was performed of all infants presenting to our Cardiology service with hypocalcaemic cardiomyopathy. Laboratory profiles were documented for each infant, specifically serum calcium, alkaline phosphatase, parathyroid hormone (PTH) and 25OH-Vitamin D. Maternal blood results and the method of infant feeding were also documented.
Results: Two male infants presented between January 2009 and March 2010, aged 24 days and 3 months respectively. Both were exclusively breastfed, and were of African origin. Intubation, ventilation and inotropic support was required for each baby. Echocardiography confirmed dilated cardiomyopathy. Blood results were consistent with vitamin D deficiency; calcium 1.23mmol/l and 1.28mmol/l, alkaline phosphatase 988U/l and 1487U/L, PTH 150.6ng/l and 392ng/l and 25OHvitamin D 12nmol/l and 10.4nmol/l. The mothers were both confirmed as being vitamin D deficient.
Conclusions: Hypocalcaemia is a recognised cause of dilated cardiomyopathy. Vitamin D-deficient rickets is re-emerging as a clinical entity in Ireland. The Food Safety Authority of Ireland recommends that all exclusively breastfed infants, particularly those who are dark-skinned, receive 200 IU of vitamin D from birth to 12 months of age. This is not universally implemented. To date there are no further recommendations to assess or improve vitamin D status in population subgroups, such as pregnant women. Health professionals and parents should be made aware that vitamin D deficiency is prevalent in Ireland, particularly among darkskinned infants.
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Hensey, C., Kozdoba, O., White, M. et al. 1043 Vitamin D Deficiency and Hypocalcaemic Cardiomyopathy. Pediatr Res 68 (Suppl 1), 518 (2010). https://doi.org/10.1203/00006450-201011001-01043
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DOI: https://doi.org/10.1203/00006450-201011001-01043