Published online August 1, 2008
PEDIATRICS Vol. 122 No. 2 August 2008, pp. 398-417 (doi:10.1542/10.1542/peds.2007-1894)
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STATE-OF-THE-ART REVIEW ARTICLE

Vitamin D Deficiency in Children and Its Management: Review of Current Knowledge and Recommendations

Madhusmita Misra, MD, MPHa, Danièle Pacaud, MDb, Anna Petryk, MDc, Paulo Ferrez Collett-Solberg, MDd, Michael Kappy, MD, PhDe on behalf of the Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society

a Pediatric Endocrine and Neuroendocrine Units, Massachusetts General Hospital, Boston, Massachusetts
b Division of Pediatric Endocrinology, Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
c Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
d Instituto Estadual de Diabetes e Endocrinologia, Rio de Janeiro, Brazil
e Children's Hospital Association, University of Colorado Health Sciences Center, Denver, Colorado

ABSTRACT

Given the recent spate of reports of vitamin D deficiency, there is a need to reexamine our understanding of natural and other sources of vitamin D, as well as mechanisms whereby vitamin D synthesis and intake can be optimized. This state-of-the-art report from the Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society was aimed to perform this task and also reviews recommendations for sun exposure and vitamin D intake and possible caveats associated with these recommendations.


Key Words: food fortification • breastfeeding • calcium • supplements • vitamin D

Abbreviations: AAP—American Academy of Pediatrics • 25(OH)-D—25(OH)-vitamin D • UVR—ultraviolet radiation • PTH—parathyroid hormone • 1,25(OH)2-D—1,25-dihydroxy vitamin D • ALP—alkaline phosphatase • DBP—vitamin D–binding protein • 24,25(OH)2-D—24,25-dihydroxy vitamin D • MED—minimum erythema dose • mAb—monoclonal antibody • HPLC—high-pressure liquid chromatography • SPF—sun protection factor


Accepted Nov 26, 2007.


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