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Congestive heart failure caused by vitamin D deficiency?
L Brunvand1, P Hågå, S E Tangsrud
1Department of Paediatrics, Ullevål Hospital, Oslo, Norway.
Insights
Severe vitamin D deficiency in infants can cause congestive heart failure and hypocalcaemia. Prompt treatment with calcium, conventional therapy, and calcitriol reversed heart failure, though motor delays persisted.
Area of Science:
- Pediatrics
- Endocrinology
- Cardiology
Background:
- Vitamin D deficiency is a growing concern in pediatric populations.
- Severe deficiency can lead to significant metabolic and cardiovascular complications.
- Hypocalcaemia is a known complication of vitamin D deficiency.
Observation:
- A 3.5-month-old infant presented with severe vitamin D deficiency, profound hypocalcaemia, and hyperphosphataemia.
- The infant exhibited a dilated left ventricle, reduced myocardial contractility, and congestive heart failure.
- Depressed thyroid function, with subnormal thyroxine and undetectable TSH, was also noted.
Findings:
- The infant showed a prompt positive response to calcium infusions, anticongestive therapy, and calcitriol.
- At 3 years old, the patient's myocardial function normalized without ongoing medication.
- Persistent motor delay was observed despite the resolution of cardiac symptoms.
Implications:
- Severe vitamin D deficiency and associated hypocalcaemia can be a direct cause of reversible congestive heart failure in infants.
- Early diagnosis and treatment are crucial for managing cardiovascular complications.
- Long-term neurodevelopmental monitoring is warranted in infants with severe deficiency and associated complications.
Abstract:
We describe a child, 3.5 months old, with severe vitamin D deficiency, profound hypocalcaemia, hyperphosphataemia, dilated left ventricle, severely reduced myocardial contractility and congestive heart failure. She also had depressed thyroid function with subnormal thyroxine and non-detectable serum thyrotropin (TSH) levels. The child promptly responded to calcium infusions, conventional anticongestive therapy and calcitriol. She is now 3 years old and received no medication. Myocardial function is normal but she has motor delay. We believe that her transitory congestive heart failure was caused by severe vitamin D deficiency with profound hypocalcaemia.