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Can Vitamin D Deficiency Produce an Unusual Pain Syndrome?

Can Vitamin D Deficiency Produce an Unusual Pain Syndrome? Abstract An unusual pain occurred in five patients in the presence of compromised vitamin D status and resolved 5 to 7 days after supplementation with vitamin D in the form of ergocalciferol. The pain had a hyperesthetic quality and did not respond to the use of analgesics, including opiate derivatives. Treatment with therapeutic levels of a tricyclic antidepressant did not bring relief of symptoms. In one case, months after treatment and subsequent improvement of vitamin D status and pain, the vitamin D status again declined and the pain recurred. The pain again resolved with vitamin D replacement and improvement of levels. There may be a pain syndrome associated with vitamin D depletion that appears as hyperesthesia worsened by light, superficial pressure or even small increments of movement. This pain restricts mobility and function and may lead to further complications, such as pressure sores. (Arch Intern Med. 1991;151:1662-1664) References 1. Shock NW, Greulich RC, Andres R, et al. Normal Human Aging: The Baltimore Longitudinal Study of Aging . Washington, DC: US Dept of Health and Human Services; 1984. NIH publication 84-2450. 2. Pike JW, Goozle LL, Haussler MR. Biochemical evidence for 1,25-dihydroxyvitamin D receptor macromolecules in parathyroid, pancreatic, pituitary, and placental tissues . Life Sci . 1980;26:407-414.Crossref 3. Gelbard HA, Stern PH, U'Prichard DC. 1 Alpha 25-dihydroxyvitamin D3 nuclear receptors in pituitary . Science . 1980;209:1247-1249.Crossref 4. Merke J, Milde P, Lewicka S, et al. Identification and regulation of 1,25dihydroxyvitamin D3 receptor activity and biosynthesis of 1,25-dihydroxyvitamin D3: studies in cultured bovine aortic endothelial cells and human dermal capillaries . J Clin Invest . 1989;83:1903-1915.Crossref 5. Barsony J, McKoy W, DeGrange DA, Liberman UA, Marx SJ. Selective expression of a normal action of the 1,25-dihydroxyvitamin D3 receptor in human skin fibroblasts with hereditary severe defects in multiple actions of that receptor . J Clin Invest . 1989;83:2093-2101.Crossref 6. Reichel H, Koeffler HP, Bishop J, Norman AW. 25(OH)2D3 metabolism by lipopolysaccharide-stimulated normal human macrophages . J Clin Endocrinol Metab . 1987;64:1-7.Crossref 7. Merke J, Hofmann W, Goldschmidt D, Ritz E. Demonstration of 1,25(OH)2D3 receptors and action in vascular smooth muscle cells in vitro . Calcif Tissue Int . 1987;41:112-114.Crossref 8. Provvedini DM, Tsoukas CD, Deftos LJ, Manolagas SC. 1,25-Dihydroxyvitamin D3 receptors in human leukocytes . Science . 1983;221:1181-1183.Crossref 9. Pillai S, Bikle DD, Elias PM. 1,25-Dihydroxyvitamin D production and receptor binding in human keratinoytes varies with differentiation . J Biol Chem . 1988;263:5390-5395. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Can Vitamin D Deficiency Produce an Unusual Pain Syndrome?

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1991.00400080144029
Publisher site
See Article on Publisher Site

Abstract

Abstract An unusual pain occurred in five patients in the presence of compromised vitamin D status and resolved 5 to 7 days after supplementation with vitamin D in the form of ergocalciferol. The pain had a hyperesthetic quality and did not respond to the use of analgesics, including opiate derivatives. Treatment with therapeutic levels of a tricyclic antidepressant did not bring relief of symptoms. In one case, months after treatment and subsequent improvement of vitamin D status and pain, the vitamin D status again declined and the pain recurred. The pain again resolved with vitamin D replacement and improvement of levels. There may be a pain syndrome associated with vitamin D depletion that appears as hyperesthesia worsened by light, superficial pressure or even small increments of movement. This pain restricts mobility and function and may lead to further complications, such as pressure sores. (Arch Intern Med. 1991;151:1662-1664) References 1. Shock NW, Greulich RC, Andres R, et al. Normal Human Aging: The Baltimore Longitudinal Study of Aging . Washington, DC: US Dept of Health and Human Services; 1984. NIH publication 84-2450. 2. Pike JW, Goozle LL, Haussler MR. Biochemical evidence for 1,25-dihydroxyvitamin D receptor macromolecules in parathyroid, pancreatic, pituitary, and placental tissues . Life Sci . 1980;26:407-414.Crossref 3. Gelbard HA, Stern PH, U'Prichard DC. 1 Alpha 25-dihydroxyvitamin D3 nuclear receptors in pituitary . Science . 1980;209:1247-1249.Crossref 4. Merke J, Milde P, Lewicka S, et al. Identification and regulation of 1,25dihydroxyvitamin D3 receptor activity and biosynthesis of 1,25-dihydroxyvitamin D3: studies in cultured bovine aortic endothelial cells and human dermal capillaries . J Clin Invest . 1989;83:1903-1915.Crossref 5. Barsony J, McKoy W, DeGrange DA, Liberman UA, Marx SJ. Selective expression of a normal action of the 1,25-dihydroxyvitamin D3 receptor in human skin fibroblasts with hereditary severe defects in multiple actions of that receptor . J Clin Invest . 1989;83:2093-2101.Crossref 6. Reichel H, Koeffler HP, Bishop J, Norman AW. 25(OH)2D3 metabolism by lipopolysaccharide-stimulated normal human macrophages . J Clin Endocrinol Metab . 1987;64:1-7.Crossref 7. Merke J, Hofmann W, Goldschmidt D, Ritz E. Demonstration of 1,25(OH)2D3 receptors and action in vascular smooth muscle cells in vitro . Calcif Tissue Int . 1987;41:112-114.Crossref 8. Provvedini DM, Tsoukas CD, Deftos LJ, Manolagas SC. 1,25-Dihydroxyvitamin D3 receptors in human leukocytes . Science . 1983;221:1181-1183.Crossref 9. Pillai S, Bikle DD, Elias PM. 1,25-Dihydroxyvitamin D production and receptor binding in human keratinoytes varies with differentiation . J Biol Chem . 1988;263:5390-5395.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Aug 1, 1991

References