Treatment of rickets and tetany with a single massive dose of vitamin D: Vitamin D shock therapy

Abstract

Rickets and tetany can be cured by peroral administration of one single dose of 600,000 international units of vitamin D. The curative effect of this treatment is more prompt than that obtained with the daily administration of small doses. Serum calcium and serum phosphorus become normal and roentgenographic evidence of calcification shows within one week. The most impressive effect is the rapid rise of serum calcium. Tetanic convulsions did not recur after vitamin D shock therapy, and all other symptoms of hyperirritability disappeared usually within two days without any additional therapy. Hypernormal values of serum phophorus may occur after vitamin D shock therapy. They usually decline to a normal level in from two to four weeks after the treatment. The following conditions may be considered as indications for vitamin D shock therapy: neonatal and infantile tetany, severe rickets, rickets associated with pneumonia or pertussis, rickets associated with chronic infections, and indifference of the parents of a rachitic or tetanic child. No contraindication seems to exist. No toxicity was manifested in 150 children treated with massive doses of vitamin D. The proper dosage is 600,000 international units, incorporated in milk. Vitamin D is effective also when administered subcutaneously. The possibility of a successful vitamin D shock prophylaxis over the entire winter period with a single dose of 400,000 to 600,000 units is discussed. Rickets and tetany can be cured by peroral administration of one single dose of 600,000 international units of vitamin D. The curative effect of this treatment is more prompt than that obtained with the daily administration of small doses. Serum calcium and serum phosphorus become normal and roentgenographic evidence of calcification shows within one week. The most impressive effect is the rapid rise of serum calcium. Tetanic convulsions did not recur after vitamin D shock therapy, and all other symptoms of hyperirritability disappeared usually within two days without any additional therapy. Hypernormal values of serum phophorus may occur after vitamin D shock therapy. They usually decline to a normal level in from two to four weeks after the treatment. The following conditions may be considered as indications for vitamin D shock therapy: neonatal and infantile tetany, severe rickets, rickets associated with pneumonia or pertussis, rickets associated with chronic infections, and indifference of the parents of a rachitic or tetanic child. No contraindication seems to exist. No toxicity was manifested in 150 children treated with massive doses of vitamin D. The proper dosage is 600,000 international units, incorporated in milk. Vitamin D is effective also when administered subcutaneously. The possibility of a successful vitamin D shock prophylaxis over the entire winter period with a single dose of 400,000 to 600,000 units is discussed.