Vitamin D deficiency rickets became a rare disease in industrialized
countries due to vitamin D supplementation in infants and nutritional
guidelines. Symptoms of hypocalcemia due to vitamin D deficiency
rickets may be life threatening. We report a case of a 16 months old
infant who initially presented with stridor that was misdiagnosed as
viral laryngitis. He presented, two weeks later, a cardiorespiratory
arrest related to a laryngospasm secondary to severe hypocalcemia
(ionized calcium level: 0.42 mmol/l,total calcium level: 1.15 mmol/). He
was successfully resuscitated and vitamin D deficiency rickets was
diagnosed. The medical history revealed that the infant was exclusively
breast fed without vitamin D supplementation till the age of 10 months
and also deprived from other milk products intentionally by the parents
due to cultural habits. The laboratory investigations showed an
elevated alkaline phosphatase level at 577 U/l, a normal phosphatemia
level at 2 mmol/l, a decreased 25 (OH) cholecalciferol at 5.7 mcg/l,a
normal calciuria level at 0.35 mol/mol of creatinine and an increased
parathyroid hormone level at 325 ng/l. Cardiocirculatory arrest
secondary to vitamin D deficiency rickets is very rare. The aim of this
presentation is to highlight the symptoms of vitamin D deficiency
rickets and to raise pediatricians' awareness to the necessity of
including the diagnosis of hypocalcemia in case of stridor especially if
the nutritional history or ethnic origin of the infant predispose to
vitamin D deficiency. Vitamin D supplementation is important for some
ethnic minority population, whom are faced with the risk of developing
this disease