Severe Hypocalcemia and Resulting Seizure Caused by Vitamin D Deficiency in an Older Patient Receiving Phenytoin: Eldecalcitol and Maxacalcitol Ointment as Potential Therapeutic Options for Hypocalcemia.
Journal
Case reports in nephrology
ISSN: 2090-6641
Titre abrégé: Case Rep Nephrol
Pays: United States
ID NLM: 101598418
Informations de publication
Date de publication:
2019
2019
Historique:
received:
14
05
2019
revised:
26
07
2019
accepted:
07
08
2019
entrez:
19
11
2019
pubmed:
19
11
2019
medline:
19
11
2019
Statut:
epublish
Résumé
An 82-year-old man treated with phenytoin for the prevention of symptomatic epilepsy was hospitalized to treat consciousness disturbance, seizure, and hypocalcemia (serum calcium: 4.6 mg/dL). Serum 25-hydroxyvitamin D level was very low (5.4 ng/mL), whereas serum calcitriol level was normal (27 pg/mL) and serum intact parathyroid hormone level was increased (369 pg/mL). He was finally diagnosed with vitamin D deficiency associated with low sunlight exposure and long-term phenytoin use for symptomatic epilepsy: phenytoin is shown to accelerate catabolism of 25-hydroxyvitamin D. Combination treatment with eldecalcitol and maxacalcitol ointments successfully normalized corrected serum calcium level: both eldecalcitol and maxacalcitol are vitamin D receptor activators used for osteoporosis and psoriasis, respectively. Our case illustrates the importance of periodic serum calcium level monitoring in patients receiving anti-epileptic drugs and the usefulness of eldecalcitol and maxacalcitol ointment as a therapeutic option for hypocalcemia, especially in countries where native vitamin D and 25-hydroxyvitamin D are not available.
Identifiants
pubmed: 31737385
doi: 10.1155/2019/3653276
pmc: PMC6815596
doi:
Types de publication
Case Reports
Langues
eng
Pagination
3653276Informations de copyright
Copyright © 2019 Seishi Aihara et al.
Déclaration de conflit d'intérêts
The authors declare that they have no conflicts of interest.
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