P. Koutkia et al., Treatment of vitamin D deficiency due to Crohn's disease with tanning bed ultraviolet B radiation, GASTROENTY, 121(6), 2001, pp. 1485-1488
In Crohn's disease, severe skeletal demineralization, secondary hyperparath
yroidism, and muscle weakness can occur. This may be caused by impaired vit
amin D absorption, resulting from extensive intestinal disease and resectio
n 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 wa
s 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 a
nd muscle weakness, and she continued to be vitamin D-deficient with a 25(O
H)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 w
eek for 6 months at the General Clinical Research Center, Boston University
Medical Center. She tolerated the irradiation well without evidence of ery
thema. After 4 weeks, her serum 25(OH)D level increased by 357% from 7 to 3
2 ng/mL, parathyroid hormone level decreased by 52% from 92 to 44 pg/mL, an
d the serum calcium level increased from 7.8 to 8.5 mg/dL. After 6 months o
f 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.