Treatment of vitamin D deficiency due to Crohn's disease with tanning bed ultraviolet B radiation.

Abstract

In Crohn's disease, severe skeletal demineralization, secondary hyperparathyroidism, and muscle weakness can occur. This may be caused by impaired vitamin D absorption, resulting from extensive intestinal disease and resection of duodenum and jejunum, where vitamin D is absorbed. We report a 57-year-old woman with a long history of Crohn's disease and short-bowel syndrome who had only 2 feet of small intestine remaining after 3 bowel resections. She was taking a daily multivitamin containing 400 IU of vitamin D(3) and was dependent on total parenteral nutrition that contained 200 IU of vitamin D and calcium (18 mEq in a 1-L bag infused over 8 hours daily) for a period of 36 months. Despite the above replacement, she complained of bone pain and muscle weakness, and she continued to be vitamin D-deficient with a 25(OH)D level <20 ng/mL. She was then exposed to ultraviolet B (UVB) radiation in a tanning bed wearing a 1-piece bathing suit for 10 minutes, 3 times a week for 6 months at the General Clinical Research Center, Boston University Medical Center. She tolerated the irradiation well without evidence of erythema. After 4 weeks, her serum 25(OH)D level increased by 357% from 7 to 32 ng/mL, parathyroid hormone level decreased by 52% from 92 to 44 pg/mL, and the serum calcium level increased from 7.8 to 8.5 mg/dL. After 6 months of UVB treatment, her serum 25(OH)D level was maintained in the normal range and was free of muscle weakness, and bone and muscle pain.

• Authors: P Koutkia, Z Lu, T C Chen, M F Holick
• Journal: Gastroenterology (Gastroenterology) Vol. 121 Issue 6 Pg. 1485-8 (Dec 2001) ISSN: 0016-5085 [Print] United States
• PMID: 11729127 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Parathyroid Hormone
• Vitamin D
• 25-hydroxyvitamin D

Topics

• Bone and Bones (physiopathology)
• Crohn Disease (complications)
• Female
• Humans
• Middle Aged
• Pain (physiopathology)
• Parathyroid Hormone (blood)
• Ultraviolet Rays
• Vitamin D (analogs & derivatives, blood)
• Vitamin D Deficiency (blood, etiology, physiopathology, radiotherapy)