Nutritional (vitamin D deficient) rickets – a neglected diagnosis? Case report
Authors:
Kutílek Štěpán 1; Rondziková Eva 1; Pečenková Kamila 1; Vracovská Martina 1; Pikner Richard 2; Švábková Marie Radová Eva 1; Benešová Šperlová Alžběta 3; Šteinerová Martina 1; Hubatová Šárka 1
Authors place of work:
Dětské oddělení, Klatovská nemocnice a. s., Klatovy
1; Oddělení klinických laboratoří, pracoviště kostního metabolizmu, Klatovská nemocnice a. s., Klatovy
2; Radiodiagnostické oddělení, Klatovská nemocnice a. s., Klatovy
3
Published in the journal:
Clinical Osteology 2020; 25(4): 213-217
Category:
Summary
Nutritional (vitamin D deficient) rickets is currently considered a rare disease, due to overall vitamin D prophylaxis throughout the infantile period. However, nutritional rickets has to considered in children from families of low socio-economic status and in infants of uncooperative parents. We present a case of a two year old girl, from a family of very low socio-economic status, where uncooperative parents completely neglected vitamin D prophylaxis in the first year of life and the patient was referred because of psychomotor retardation and late onset of (waddling) gait. Biochemical assessment revealed high values of serum alkaline phosphatase activity (S-ALP, 19 µkat/L) and parathyroid hormone, wrist X-ray bore typical rachitic signs (cupping, fraying). Because of uncooperative family, the girl received “stoss“ therapy of 300,000 IU ergocalciferol once monthly for 3 consecutive months, which resulted in normalization of biochemical indices and complete healing of the rickets. Nutritional rickets is not an extinct disease and should be kept in mind, especially in children with low socio-economic background, and in cases of psychomotor retardation and, especially, skeletal deformities and/or waddling gait.
Keywords:
alkaline phosphatase – parathyroid hormone – psychomotor retardation – rickets – vitamin D
Zdroje
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Štítky
Clinical biochemistry Paediatric gynaecology Paediatric radiology Paediatric rheumatology Endocrinology Gynaecology and obstetrics Internal medicine Orthopaedics General practitioner for adults Radiodiagnostics Rehabilitation Rheumatology Traumatology OsteologyČlánok vyšiel v časopise
Clinical Osteology
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