Single High-Dose Oral Vitamin D3 Therapy (Stoss): A Solution to Vitamin D Deficiency in Children With Inflammatory Bowel Disease?

Objectives: Vitamin D deficiency is common in children with inflammatory bowel disease (IBD). The aim of this study was to determine the safety and efficacy of stoss therapy on vitamin D levels during a period of 6 months in children with IBD and vitamin D deficiency (<50 nmol/L). Methods: A retrospective chart review was undertaken, focusing upon children managed in the IBD clinic at Sydney Children's Hospital between 2006 and 2010. Those with a 25-hydroxyvitamin D (25-OHD) level <50 nmol/L and those who received stoss therapy were included in this study. Results: A total of 76 children received stoss therapy. There was a significant and sustained increase in 25-OHD levels at all of the time points compared with baseline (40.8 ± 7.5 nmol/L), 1 month (145.6 ± 51.8 nmol/L), 3 months (87.1 ± 28.4 nmol/L), and 6 months 69.2 ± 31.3 nmol/L). There were no significant changes in serum calcium, phosphate, or parathyroid hormone at any time points. Conclusions: Stoss therapy safely and effectively achieved and maintained a level of 25-OHD >50 nmol/L during 6 months in these children with IBD. Further prospective studies are now required to confirm this finding and establish whether this intervention has other benefits.

[1]  J. Morton,et al.  Single high-dose oral vitamin D3 (stoss) therapy--a solution to vitamin D deficiency in children with cystic fibrosis? , 2013, Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society.

[2]  J. McGrath,et al.  Vitamin D and health in pregnancy, infants, children and adolescents in Australia and New Zealand: a position statement , 2013, The Medical journal of Australia.

[3]  A. Day,et al.  Crohn's and colitis in children and adolescents. , 2012, World Journal of Gastroenterology.

[4]  E. Szigethy,et al.  Health supervision in the management of children and adolescents with IBD: NASPGHAN recommendations. , 2012, Journal of pediatric gastroenterology and nutrition.

[5]  Hong Zhang,et al.  Protective role of 1,25(OH)2vitamin D3 in the mucosal injury and epithelial barrier disruption in DSS-induced acute colitis in mice , 2012, BMC Gastroenterology.

[6]  R. Pérez-Cano,et al.  Vertebral fractures in patients with inflammatory bowel disease COMPARED with a healthy population: a prospective case-control study , 2012, BMC Gastroenterology.

[7]  C. Gordon,et al.  Treatment of vitamin D insufficiency in children and adolescents with inflammatory bowel disease: a randomized clinical trial comparing three regimens. , 2012, The Journal of clinical endocrinology and metabolism.

[8]  C. Gordon,et al.  Skeletal health of children and adolescents with inflammatory bowel disease. , 2011, Journal of pediatric gastroenterology and nutrition.

[9]  C. Porter,et al.  Risk of diagnosed fractures in children with inflammatory bowel diseases , 2011, Inflammatory bowel diseases.

[10]  C. Gordon,et al.  Prevalence and Risk Factors for Hypovitaminosis D in Young Patients With Inflammatory Bowel Disease , 2011, Journal of pediatric gastroenterology and nutrition.

[11]  A. Day,et al.  Vitamin D Deficiency in Children with Inflammatory Bowel Disease , 2011, Digestive Diseases and Sciences.

[12]  R. Langan,et al.  Recognition and management of vitamin D deficiency. , 2009, American family physician.

[13]  S. Judd,et al.  Treatment and prevention of vitamin D insufficiency in cystic fibrosis patients: comparative efficacy of ergocalciferol, cholecalciferol, and UV light. , 2009, The Journal of clinical endocrinology and metabolism.

[14]  Z. Mughal,et al.  A single high dose of ergocalciferol can be used to boost 25-hydroxyvitamin D levels in children with kidney disease , 2009, Pediatric Nephrology.

[15]  K. Carson,et al.  Current treatment recommendations for correcting vitamin D deficiency in pediatric patients with cystic fibrosis are inadequate. , 2008, The Journal of pediatrics.

[16]  B. Hollis,et al.  25-Hydroxylation of vitamin D3: relation to circulating vitamin D3 under various input conditions. , 2008, The American journal of clinical nutrition.

[17]  R. Heaney,et al.  Pharmacokinetics of a single, large dose of cholecalciferol. , 2008, The American journal of clinical nutrition.

[18]  C. Gordon,et al.  Vitamin D Status in Children and Young Adults With Inflammatory Bowel Disease , 2006, Pediatrics.

[19]  M. Meerkin,et al.  Annual intramuscular injection of a megadose of cholecalciferol for treatment of vitamin D deficiency: efficacy and safety data , 2005, The Medical journal of Australia.

[20]  R. Heaney Functional indices of vitamin D status and ramifications of vitamin D deficiency. , 2004, The American journal of clinical nutrition.

[21]  H. K. Harms,et al.  A paediatric Crohn's disease activity index (PCDAI). Is it useful? , 1994, Acta paediatrica (Oslo, Norway : 1992). Supplement.

[22]  H. Çaksen,et al.  Comparison of Low and High Dose of Vitamin D Treatment in Nutritional Vitamin D Deficiency Rickets , 2003, Journal of pediatric endocrinology & metabolism : JPEM.