Rickets

Rickets is a disorder caused by a lack of vitamin D, calcium, or phosphate. It leads to softening and weakening of the bones.

Causes—-

  • Lack of vitamin D or calcium
  • Genetic defect

Hypophosphatemic rickets involves a genetic defect that causes abnormalities in the way the kidneys and bones deal with phosphate.

  • Underlying disease

Rickets occasionally develops in children with rare forms of kidney, liver and gut diseases that affect the absorption and metabolism of vitamins and minerals.

  • Northern latitudes

Children who live in geographical locations where there is less sunshine are at higher risk of rickets.

  • Premature birth
  • Anti-seizure medications
  • Exclusively breast-fed.

Symptoms And Signs–

  • Bone pain or tenderness in
    1. Arms
    2. Legs
    3. Pelvis
    4. Spine
  • Dental deformities

    1. Delayed formation of teeth
    2. Decreased muscle tone
    3. Defects in the structure of teeth; holes in the enamel
    4. Increased cavities in the teeth
    5. Progressive weakness
  • Impaired growth
  • Increased bone fractures
  • Muscle cramps

  • Skeletal deformities
    1. Asymmetrical or odd-shaped skull
    2. Bow legs
    3. Rachitic rosary
    4. Pigeon shaped chest
    5. Pelvic deformities
    6. Spine deformities (scoliosis or kyphosis)

Investigations—

  • ALP (alkaline phosphatase) isoenzyme
  • Arterial blood gases
  • Blood tests (serum calcium)
  • Bone biopsy (rare)
  • Bone x-rays
  • Calcium (ionized)
  • PTH
  • Serum alkaline phosphatase
  • Serum phosphorus
  • Urine calcium

Treatment—-

 Dietary deficiency or a lack of sun exposure 

  • Daily calcium and vitamin D supplements
  • Syrup Safojas, Syrup Tinifat
  • Eating more calcium-rich food(with cautions as high calcium doses can lead to hypercalcaemia)

Hypophosphatemic rickets

Combination of phosphate supplements and a special form of vitamin D

kidney disease

Patients with rickets may require dialysis.

Bone deformity

Special brace to position child’s body appropriately as their bones grow

Complications–

  • Bone fractures
  • Dental defects
  • Failure to grow
  • Pneumonia
  • Seizures
  • Skeletal deformities

Prevention—–

Diet

  • Sources of vitamin D 
  1. oily fish
  2. liver
  3. eggs
  4. margarine
  5. breakfast cereals with added vitamin D
  • Sources of calcium 
  1. dairy products( milk, cheese and yogurt)
  2. green vegetables (broccoli and spinach)
  3. wholemeal bread
  4. dried fruits
  5. beans and pulses, such as lentils

Sunlight

It is a natural Source of Vitamin D.

  • Supplements (Vitamin D and Calcium)

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