الفهرس 
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Abstract
The study included 50 cases with symptomatic hypocalcemia. They were aged 2 months to 17 years. They were 29 male and 21 female .Besides full clinical history and accurate examination; all cases had the following investigations done: CBC, Ca, P, ALP levels, liver functions, renal function tests, PTH and vitamin D level done. They all had X -ray chest and wrist x ray.
Radiological examination and abdominal ultrasonography were also done.
In 62% of the cases nutritional vitamin D deficiency was encountered .renal rickets was present in14 % of cases, 6% had hepatic rickets, 8% had celiac disease .Antiepileptic medication was present in 4% of the cases. Hypoparathyroidism was present in 4% of the cases. Cow’s milk allergy was present in 2 % of symptomatizing hypocalcemia cases.
Vitamin D supplementation should be recommended during infancy and adolescence where periods of rapid growth of bone occur.
1. Further studies should be done with laboratory confirmation of vitamin D level regularly to establish a policy of supplementation of calcium and vitamin D in developing countries in infants and adolescent especially in vegetarian individuals.
2. Encouragement of home bearing of chicken to obtain their eggs where egg yolk is rich source of vitamin D. other foods rich in vitamin D are expensive (meat, fish, butter ,and liver).
3. In developing countries where intra muscular injection of vitamin D can be obtained without prescription on the pharmacy counter it is very important to ask in the therapeutic history about the number of I.M injection of vitamin D taken by the patient to avoid the occurrence of hyper vitamenosis D.
Good advice must be given to parents about foods rich in vitamin D(fish, meat ,butter and egg yolk) with emphasis that fresh cow’s milk is a poor source of vitamin D