An infant born with vitamin D deficiency can be identified by a number of findings.
Vitamin D deficiency should be suspected if the mother has risk factors for vitamin D deficiency during pregnancy. This includes failure to take supplemental vitamin D and minimal sunlight exposure during the pregnancy.
Clinical findings:
(1) craniotabes (softening of cranial bones, with bending under finger pressure)
Laboratory findings:
(1) low serum 25-hydroxyvitamin D (calcidiol), <= 30 nmol/L
(2) high intact parathyroid hormone (PTH) levels, > 60 ng/L
(3) low serum calcium
Imaging findings:
(1) changes of rickets in hand X-rays
Supplementation of diet by 1,000 IU ergocalciferol per day will normalize the serum PTH within 1 month.
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