Subclinical low vitamin D related to systemic sclerosis and resistant to long-term oral supplementation rapidly improves after two intramuscular injections of ergocalciferol: a retrospective observational case series.

Author:

Mallat Farid1,Aoun Maroun2,Jabbour Rita2,Hachem Samir2,Soutou Boutros1ORCID,Helou Josiane2

Affiliation:

1. Universite Saint-Joseph Faculte de medecine

2. Université Saint-Joseph Faculté de médecine: Universite Saint-Joseph Faculte de medecine

Abstract

Abstract Background Low vitamin D level is common in patients with systemic sclerosis since synthesis comprises cutaneous, gastrointestinal, hepatic, and renal steps. Oral supplementation brought less than a third of patients to a normal level. No study has yet reported effective alternatives. Aims The objective was to assess the response to intramuscular vitamin D in patients not responding to oral supplementation. Methods A retrospective series included patients, with systemic sclerosis and a history of subclinical poor vitamin D status that was resistant to at least 6 months of oral supplementation, to whom intramuscular vitamin D2 was administered. File data were collected for disease characteristics, vitamin D2 posology, and 25(OH)D serum levels. Results Twelve patients were identified, with a mean age of 51.9 years. All were women. Five had diffuse systemic sclerosisand seven had localized systemic sclerosis. The mean duration of the disease was 17.9 years, with a mean modified Rodnan skin score of 14. All patients were twice injected, at a 15-day interval, 300,000 IU of ergocalciferol into the anterior gluteus muscle. The mean serum level of 25(OH)D increased from 12.9 ng/mL before the first injection, to 23 ng/mL two weeks after the first injection, and 37.1 ng/mL four weeks after the second injection. No side effects were observed. Conclusions It is the first report of safely normalizing vitamin D levels with intramuscular ergocalciferol in patients with a connective tissue disease and a low vitamin D level refractory to oral supplementation.

Publisher

Research Square Platform LLC

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