Etiology, Clinical Manifestations, Diagnosis, and Management of Vitamin D Deficiency, Rickets, and Hypervitaminosis D

Pathophysiology and Impact of Vitamin D Deficiency on Bone Health

Introduction

Vitamin D plays a crucial role in calcium metabolism and bone health. Deficiency leads to a spectrum of skeletal and systemic disorders, including rickets in children and osteomalacia in adults.

Etiology of Vitamin D Deficiency

• Inadequate dietary intake
• Reduced sunlight exposure
• Malabsorption disorders (e.g., Crohn’s disease, celiac disease)
• Chronic kidney or liver disease impairing activation

Clinical Manifestations

Rickets (Pediatric Population)

• Bowing of the legs
• Delayed growth and motor development
• Bone pain and muscle weakness

Osteomalacia (Adult Population)

• Diffuse skeletal pain
• Fractures with minimal trauma
• Muscle weakness leading to difficulty in ambulation

Diagnosis

Serum 25-hydroxyvitamin D levels serve as the gold standard. Additional biochemical markers include elevated alkaline phosphatase, hypocalcemia, and hypophosphatemia.

Management

Vitamin D Deficiency

• Oral vitamin D supplementation (cholecalciferol or ergocalciferol)
• Encouragement of sunlight exposure
• Dietary modifications to include vitamin-D-rich foods

Hypervitaminosis D

• Discontinuation of excessive vitamin D intake
• Hydration and corticosteroids for severe cases
• Monitoring of serum calcium levels

Conclusion

Vitamin D homeostasis is essential for bone health, and both deficiency and excess pose significant risks. Early diagnosis and intervention can mitigate complications.