Standard and high dose ergocalciferol regimens for treatment of hypovitaminosis D in epileptic children and adolescents.

Abstract

Children with epilepsy are at increased risk of vitamin D deficiency. We aimed to compare the effect oftwo ergocalciferol regimens given for 90days. Epileptic patients aged 5-18years who received at least one antiepileptic drug (AED) for more than 6months and had serum 25-OHD <30ng/mL were randomized to receive 20,000IU/10d (standard dose, n=41) or 60,000IU/10d (high dose, n=41) of oral ergocalciferol. Serum Ca, P, Mg, ALP, iPTH and urine Ca/Cr ratio were measured at baseline and after 90days of treatment. Change in serum 25-OHD and vitamin D status after treatment was evaluated. The initial serum 25-OHD in the standard dose and high dose group was 19.5±4.9 and 18.4±4.6ng/mL, respectively. Serum 25-OHD after treatment was significantly higher in the high dose group (39.0±11.5 vs. 27.5±8.6ng/mL, p<0.05). The average increase in serum 25-OHD in the high dose and standard dose group was 20.6±11.4 and 7.2±7.5ng/mL, respectively (p<0.05). Normalized serum 25-OHD was achieved in 80.5% of thehigh dose group compared to 36.6% of the standard dose group (p<0.05). No adverse events were found. Patients with a BMI Z-score>0 had a 2.5 times greater risk ofcontinued hypovitaminosis D after treatment compared to those with a BMI Z-score<0 (95% CI: 1.0-5.9, p<0.05). Oral ergocalciferol 60,000IU/10d for 90days was more effective at normalizing serum 25-OHD than 20,000IU/10d in epileptic children and adolescents who were receiving AEDs.