treatment for vitamin d deficiency

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Gastroenterology. 2001 Dec;121(6):1485-8.

Treatment of vitamin D deficiency due to Crohn's disease with tanning
bed ultraviolet B radiation.
=====================================================================

Koutkia P, Lu Z, Chen TC, Holick MF.

Vitamin D, Skin, and Bone Research Laboratory, Department of Medicine,
Boston University School of Medicine, 715 Albany Street, Boston, MA
02118, USA.

In Crohn's disease, severe skeletal demineralization, secondary
hyperparathyroidism, and muscle weakness can occur. This may be caused
by impaired vitamin D absorption, resulting from extensive intestinal
disease and resection of duodenum and jejunum, where vitamin D is
absorbed. We report a 57-year-old woman with a long history of Crohn's
disease and short-bowel syndrome who had only 2 feet of small
intestine remaining after 3 bowel resections. She was taking a daily
multivitamin containing 400 IU of vitamin D(3) and was dependent on
total parenteral nutrition that contained 200 IU of vitamin D and
calcium (18 mEq in a 1-L bag infused over 8 hours daily) for a period
of 36 months. Despite the above replacement, she complained of bone
pain and muscle weakness, and she continued to be vitamin D-deficient
with a 25(OH)D level <20 ng/mL. She was then exposed to ultraviolet B
(UVB) radiation in a tanning bed wearing a 1-piece bathing suit for 10
minutes, 3 times a week for 6 months at the General Clinical Research
Center, Boston University Medical Center. She tolerated the
irradiation well without evidence of erythema. After 4 weeks, her
serum 25(OH)D level increased by 357% from 7 to 32 ng/mL, parathyroid
hormone level decreased by 52% from 92 to 44 pg/mL, and the serum
calcium level increased from 7.8 to 8.5 mg/dL. After 6 months of UVB
treatment, her serum 25(OH)D level was maintained in the normal range
and was free of muscle weakness, and bone and muscle pain.

PMID: 11729127 PubMed - indexed for MEDLINE

Publication Types, MeSH Terms, Substances, Grant Support
--------------------------------------------------------

Publication Types:

Case Reports

Research Support, Non-U.S. Gov't

Research Support, U.S. Gov't, P.H.S.

MeSH Terms:

Bone and Bones/physiopathology

Crohn Disease/complications

Female

Humans

Middle Aged

Pain/physiopathology

Parathyroid Hormone/blood

Ultraviolet Rays

Vitamin D/analogs & derivatives

Vitamin D/blood

Vitamin D Deficiency/blood

Vitamin D Deficiency/etiology

Vitamin D Deficiency/physiopathology

Vitamin D Deficiency/radiotherapy

Substances:

Parathyroid Hormone

Vitamin D

25-hydroxyvitamin D

Grant Support:

M01 RR 00533/RR/NCRR NIH HHS/United States

LinkOut - more resources
------------------------

Full Text Sources:

Elsevier Science

EBSCO

OhioLINK Electronic Journal Center

Swets Information Services

Education:

New England Research Institutes Inc.

Medical:

Crohn's Disease - MedlinePlus Health Information

Molecular Biology Databases:

PARATHYROID HORMONE - HSDB

Supplemental Content
--------------------

Click here to read

Related articles
----------------

Seasonality of vitamin D status and bone turnover in patients with
 Crohn's disease.

Aliment Pharmacol Ther. 2005 May 1; 21(9):1073-83.

Aliment Pharmacol Ther. 2005

Evidence for persistent vitamin D 1-alpha-hydroxylation in
 hemodialysis patients: evolution of serum
 1,25-dihydroxycholecalciferol after 6 months of
 25-hydroxycholecalciferol treatment.

Nephron Clin Pract. 2008; 110(1):c58-65. Epub 2008 Aug 25.

Nephron Clin Pract. 2008

Tanning is associated with optimal vitamin D status (serum
 25-hydroxyvitamin D concentration) and higher bone mineral
 density.

Am J Clin Nutr. 2004 Dec; 80(6):1645-9.

Am J Clin Nutr. 2004

ReviewEffectiveness and safety of vitamin D in relation to bone
 health.

Evid Rep Technol Assess (Full Rep). 2007 Aug; (158):1-235.

Evid Rep Technol Assess (Full Rep). 2007

Review1alpha(OH)D3 One-alpha-hydroxy-cholecalciferol--an active
 vitamin D analog. Clinical studies on prophylaxis and treatment of
 secondary hyperparathyroidism in uremic patients on chronic
 dialysis.

Dan Med Bull. 2008 Nov; 55(4):186-210.

Dan Med Bull. 2008

» See reviews...  » See all...

Cited by 3 PubMed Central articles
----------------------------------

Circulating 25-hydroxyvitamin d levels in fully breastfed infants
 on oral vitamin d supplementation.

Wagner CL, Howard C, Hulsey TC, Lawrence RA, Taylor SN, Will H,
Ebeling M, Hutson J, Hollis BW. Int J Endocrinol. 2010;
2010:235035. Epub 2009 Dec 9.

Int J Endocrinol. 2010

Serum tumor necrosis factor-alpha concentrations are negatively
 correlated with serum 25(OH)D concentrations in healthy women.

Peterson CA, Heffernan ME. J Inflamm (Lond). 2008 Jul 24; 5:10.
Epub 2008 Jul 24.

J Inflamm (Lond). 2008

Measurement of vitamin D levels in inflammatory bowel disease
 patients reveals a subset of Crohn's disease patients with
 elevated 1,25-dihydroxyvitamin D and low bone mineral density.

Abreu MT, Kantorovich V, Vasiliauskas EA, Gruntmanis U, Matuk R,
Daigle K, Chen S, Zehnder D, Lin YC, Yang H, et al. Gut. 2004 Aug;
53(8):1129-36.

Gut. 2004

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