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[Correlative pathologic studies on the role of vitamin D in vascular calcinosis in childhood]
Insights
Arterial calcifications were observed in 59 out of 64 children and young adults, with severity increasing with age. Contrary to expectations, calcifications were found even in premature infants, prompting further research into potential causes like vitamin D supplementation.
Area of Science:
- Cardiovascular pathology
- Pediatric pathology
- Arterial calcification
Context:
- Large arteries (aorta, carotid, iliac) from 64 children and young adults were analyzed.
- Calcium deposits were visualized macroscopically using the Kossa reaction and histologically.
Purpose:
- To investigate the prevalence and characteristics of arterial calcification in pediatric and young adult populations.
- To examine age-related differences and segmental variations in arterial calcification.
- To address concerns regarding potential links between vitamin D supplementation and arterial calcification.
Summary:
- Calcium incrustations were present in 59 of 64 subjects, appearing as varied patterns in different arterial segments.
- Calcifications were observed even in premature infants, challenging existing literature.
- The severity of calcifications increased with age, with pathological changes ranging from internal elastic lamina fragmentation to compact calcification foci.
Impact:
- Findings indicate arterial calcification is more prevalent in younger populations than previously thought.
- The study highlights the need for further investigation into the etiology of pediatric arterial calcification, including the role of vitamin D.
- Results may inform future guidelines on rickets prevention and arterial health in children.
Abstract:
The large arteries (aorta, common carotid arteries with the adjacent segments of the internal and external carotid arteries, common, internal and external iliac arteries) of 64 children and young adults were sectioned longitudinally and removed with adjacent tissue. The macroscopic demonstration of calcium deposits was performed by using the Kossa reaction modified by Meyer and Stelzig (16). The macroscopically positive cases were selected for histology, fixed in formalin and embedded in paraffin. The total material comprised 4 premature infants, 6 mature neonates, 8 babies aged 1 to 12 months, 13 children aged 1 to 5 years, 12 school children between 6 and 13 years, and 21 young adults between 15 and 30 years. Calcium incrustations are visible in various arterial segments (in 59 of the 64 cases examined) as black dots, stripes, patches or polygonal figures. Extent and density of calcifications display differences not only from case to case but also from segment to segment. Contrary to the literature, disseminated calcinoses were even detected in some of our prematurely born babies. The severity of calcifications increases with increasing age. Calcium incrustations in mature neonates do not appear exclusively in the common and internal iliac arteries, but also in the other arteries examined. The least pathological changes consist in a focal disintegration, calcium impregnation and circumscribed fragmentation of the lamina elastica interna. In advanced cases, the inner layers of the wall show additional compact calcification foci of different size. We were afraid that the high single doses of vitamin D, within the frame-work of rickets prevention, may cause calcium deposits in the arteries of children. A clarification of these problems might be accomplished by comparative studies of the population in countries where rickets prevention is not practised by application of such high doses.