Vitamin D deficiency disease tetany

An overview of the disease known as baby tetany disease, more common in a pediatric age, especially 3 -9 months of the highest incidence rates, winter and spring styles. Mainly due to a lack of vitamin D, parathyroid compensatory function inadequate or various other factors, the blood to reduce intracellular calcium, excitatory neurons increased, caused in part or in whole muscle twitch. Pathology Disease incidence and causes rickets the same, but the bone did not change significantly and are compensatory parathyroid dysfunction. Children of normal calcium 2.7mmo1 2.2 ~ / L (9-11mg/d1) calcium were 40% for the combination of calcium, and plasma protein binding, can not enter the cells of capillaries; 60% of free calcium. Both in dynamic equilibrium, by vitamin D, parathyroid hormone, calcitonin and other adjustments. Compensatory in parathyroid dysfunction, calcium were unable to maintain the normal level. When calcium below the 1.7 ~ 1.9mmo1 / L, or less than 1mmo1 calcium ion / L, convulsions may occur or tetany. Calcium reduced with the following factors : (1) of vitamin D deficiency early If the parathyroid not compensate its lower calcium, as well as calcium and phosphorus normal lower Clinical there hypocalcemia performance and bone changes are not significant. (2) spring and summer outdoor activities, increased vitamin D synthesis in vivo surges, or the beginning of vitamin D therapy, is not so calcified bones accelerated calcification, serum calcium lot of calm in the skeleton, bone calcification accelerated, the old bone decalcification reduced intestinal calcium absorption is relatively short, making the calcium decline. (3) infection, fever, hunger, because of tissue decomposition, phosphorus release from the cells, elevated serum phosphate, calcium declined. (4) within six months babies, the fastest growth, the need for more calcium, if insufficient food supply, be vitamin D deficiency is easy incidence. (5) Long-term diarrhea or obstructive jaundice, vitamin D and calcium reduce the absorption, resulting in lower serum calcium. (6) When the blood pH rises, such as hyperventilation-induced respiratory alkalosis. alkaline solution injection or excessive correction of acidosis, can accelerate bone calcium deposition, resulting in lower serum calcium. Clinical manifestations (1) a typical symptoms. Convulsion for infants the most common symptoms. Often suddenly, in short duration seconds species, the elderly several minutes. Daily attack from several to dozens of times, a clear sense of intermittent period, as usual activities. Light were the only two staring, irritability or partial facial muscles twitch. Not generally fever, or if infected with frequent seizures and the time is too long, the body temperature can be increased. 2. Tetany children and older children styles. Consciousness - attack, wrist flexion, extension fingers, thumb adduction ankle plantar flexion, the foot within the Department of admission (figure). 3. Laryngeal spasm more common in infants. As the throat muscle cramps and respiratory difficulties and inspiratory roar Woo, will be re-addressed to the suffocation deaths, attention should be paid. (2) hidden signs of hypocalcemia in patients close to the threshold level, but not above the clinical symptoms, said tetany recessive disease. At this point its neuromuscular stress increased, peripheral nerve stimulation can induce partial muscle twitch, the following signs : 1. Facial nerve levy (Chvostek's levy) to hammer finger tapping or spontaneous delivery zygomatic ears below the facial nerve, ipsilateral upper lip and eyelid muscle contraction rapidly. 2. Hand pull take hold levy (Trousseau's levy) to wrap up the upper arm blood pressure cuffs, Pressure to make radial artery pulsatility suspended 2 -3 minutes after take hold hands pull the levy. 3. Peroneal nerve levy (Peronea1 sign) Tap knee lateral fibular head to the peroneal nerve, we can see valgus foot dorsiflexion.