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维生素 D 缺乏症

最后审阅: 10 Nov 2024
最后更新: 22 Jun 2023

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 弓形腿
  • 长骨末端膨大
  • 牙齿萌出延迟和早期龋齿
  • 胸部畸形
  • 抽痛、疼痛性骨不适和/或易激惹
  • 头部出汗
  • 局部或者全身骨压痛
  • 近端肌肉无力
  • 串珠肋
  • 额部隆起
  • 摇摆步态
完整详情

其他诊断因素

  • 生长发育受限
  • 达到运动发育里程碑的时间延迟
  • 乏力和不适感
  • 低钙血症症状
完整详情

危险因素

  • 日照不足
  • 皮肤色素沉着加重
  • 年龄>50 岁
  • 膳食性和补充性维生素 D 摄入不足
  • 吸收不良
  • 肥胖
  • 用药
  • 基因突变
  • 肿瘤
  • 慢性肾病
  • 肉芽肿性疾病
  • 原发性甲状旁腺功能亢进症
  • 甲状腺功能亢进症
完整详情

诊断性检查

首要检查

  • 血清 25 -羟基维生素 D
  • 血清钙
  • 空腹血清磷
  • 血清碱性磷酸酶
  • 膝关节和腕关节的 X 光平片
完整详情

需考虑的检查

  • 全段甲状旁腺激素 (PTH)
  • 血清 1,25-二羟基维生素 D
  • 骨密度(DEXA)扫描
完整详情

治疗流程

急症处理

不足症

缺乏症

撰稿人

作者

Michael F. Holick, PhD, MD

Director Vitamin D, Skin, and Bone Research Laboratory

Director Ehlers-Danlos Clinical Research Programme

Professor of Medicine, Physiology, and Biophysics and Molecular Medicine

Departments of Medicine, Physiology, and Biophysics

Section of Endocrinology, Diabetes, Nutrition and Weight Management

Boston University School of Medicine

Boston

MA

利益声明

MFH has a clinical research contract and consultant for Solius Inc., clinical and basic research contract and grant from Carbogen-Amcis, and is a consultant for Faes Farma. He is a speaker for Pulse Ltd, Abbott Inc., Sanofi Inc., Menarini Inc., and a board member Bridge to Life. He also chaired the Endocrine Society’s practice guidelines on vitamin D. MFH is an author of references cited in this topic.

同行评议者

Vin Tangpricha, PhD, MD

Professor of Medicine

Division of Endocrinology

Metabolism and Lipids

Emory University School of Medicine

Atlanta

GA

利益声明

VT is an author of references cited in this topic.

Stefan Pilz, MD

General Practitioner

Resident at the Department of Internal Medicine

Division of Endocrinology and Nuclear Medicine

Medical University of Graz

Graz

Austria

利益声明

SP is an author of references cited in this topic.

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