Rickets
It is a disorder primarily caused by lack of vitamin D, calcium or phosphate, which leads to softening and weakening of bones.Alternative Names
Vitamin D deficiency, osteomalacia in children, renal ricketsCauses and Risk Factors
Vitamin D helps the body properly control calcium and phosphorus levels in the body. When the body lacks vitamin A, is unable to adequately control the levels of these minerals. If the blood levels of these minerals become too low, the body may produce other body hormones to stimulate release of calcium and phosphate from the bones, which leads to weak and soft bones present.
Vitamin D can be absorbed from food or produced by the skin when it is exposed to sunlight. Lack of vitamin D production by the skin can occur if the person is confined indoors, work indoors during daylight hours or live in climates with little exposure to sunlight.
Because vitamin D is a fat soluble vitamin, malabsorption disorders that reduce digestion or absorption of fats will decrease the ability of vitamin D to be absorbed into the body.
Deficiency of vitamin D in the diet can occasionally be seen in vegetarians, who do not drink milk products, or those who have lactose intolerance (those who have trouble digesting dairy products). Babies fed exclusively on breast milk may also develop vitamin D deficiency, because the milk does not supply the proper amount of the vitamin. This can be a particular problem for darker-skinned children in winter months when sunlight levels lower.
Inadequate intake of calcium and phosphorus in the diet can also lead to rickets. Rickets caused by a dietary lack of these minerals is rare in developed countries because calcium and phosphorus found in milk and green leafy vegetables.
Your genes may increase your risk of rickets. Hereditary rickets is a disease that is transmitted through families and occurs when the kidneys are unable to retain phosphorus. Rickets may also be caused by kidney disorders involving renal tubular acidosis.
Occasionally, rickets may also occur in children who have liver problems or can not convert vitamin D to its active form.
Rickets is rare in the United States. Most likely to occur during periods of rapid growth when the body demands high levels of calcium and phosphorus. It is usually seen in children 6 to 24 months of age and is uncommon in newborns.Symptoms
Bone pain or tenderness
arms
legs
column
pelvis
Skeletal deformities
bowlegged
forward projection of the breastbone (pigeon chest)
Bumps in the rib cage (rachitic rosary)
Skull asymmetrical or odd-shaped
spinal deformities (spine curves abnormally, including scoliosis or kyphosis)
Pelvic deformities
Increased tendency toward bone fractures
Dental deformities
Delayed formation of teeth
defects in the structure of teeth, holes in the enamel
increased incidence of tooth decay (dental caries)
progressive weakness
decreased muscle tone (loss of muscle strength)
Muscle cramps
Poor growth
Short stature adults within 1.52 m (5 ft) high
Signs and tests
A physical exam reveals tenderness or pain in the bones, rather than in the joints or muscles.
The following tests may help diagnose rickets:
Blood tests (serum calcium) may show low levels of calcium.
tetany (prolonged muscle spasm) which may occur if serum levels of calcium are low
Chvostek's sign may be positive (a spasm of facial muscles when facial nerve is tapped) indicating low serum calcium levels
Serum phosphorus may be low.
Serum alkaline phosphatase may be high.
Arterial blood gases may reveal metabolic acidosis.
X-rays of the bones may show loss of calcium from bones or changes in form or structure of these.
A bone biopsy is rarely performed but will confirm rickets.
Other tests and procedures include the following:
PTH
Urine calcium
Calcium (ionized)
Isoenzyme of ALP (alkaline phosphatase)
Treatment
The goal of treatment is to relieve symptoms and correct the cause of this condition. You must treat the underlying cause to prevent recurrence.
With the replacement of deficient calcium, phosphorus or vitamin D will eliminate most symptoms of rickets. Dietary sources of vitamin D include fish, liver and processed milk. It is recommended that exposure to moderate amounts of sunlight. Treating rickets caused by metabolic abnormalities may require a special prescription for vitamin D.
Good posture and the use of braces to help reduce or prevent deformities. In addition, you may need surgical correction of some skeletal deformities.Expectations (prognosis)
The disorder can be corrected with replacement of minerals and vitamin D deficient. Laboratory values and x-rays usually improve after almost a week of treatment, although some cases may be resistant and require large doses of minerals and vitamin D.
If rickets is not corrected while children are still growing, skeletal deformities and short stature may be permanent. Conversely, if it is corrected while the child is young, skeletal deformities often diminish or disappear over time.Complications
Chronic skeletal pain
Skeletal deformities
Skeletal fractures, may occur without cause
Calling your health care
Call your pediatrician if you notice symptoms of rickets.Prevention
Rickets may be avoided by having your child maintain an adequate intake of calcium, phosphorus and vitamin D. This may require dietary supplementation in people with gastrointestinal disorders or other conditions, which you should consult your pediatrician.
The renal causes of malabsorption of vitamin D should be treated promptly and levels of calcium and phosphorus should be monitored regularly in people with kidney disease.
Genetic counseling can help people with a family history of inherited disorders that can cause rickets.
source: clinicadam.com
READ MORE - Rickets and the efect
It is a disorder primarily caused by lack of vitamin D, calcium or phosphate, which leads to softening and weakening of bones.Alternative Names
Vitamin D deficiency, osteomalacia in children, renal ricketsCauses and Risk Factors
Vitamin D helps the body properly control calcium and phosphorus levels in the body. When the body lacks vitamin A, is unable to adequately control the levels of these minerals. If the blood levels of these minerals become too low, the body may produce other body hormones to stimulate release of calcium and phosphate from the bones, which leads to weak and soft bones present.
Vitamin D can be absorbed from food or produced by the skin when it is exposed to sunlight. Lack of vitamin D production by the skin can occur if the person is confined indoors, work indoors during daylight hours or live in climates with little exposure to sunlight.
Because vitamin D is a fat soluble vitamin, malabsorption disorders that reduce digestion or absorption of fats will decrease the ability of vitamin D to be absorbed into the body.
Deficiency of vitamin D in the diet can occasionally be seen in vegetarians, who do not drink milk products, or those who have lactose intolerance (those who have trouble digesting dairy products). Babies fed exclusively on breast milk may also develop vitamin D deficiency, because the milk does not supply the proper amount of the vitamin. This can be a particular problem for darker-skinned children in winter months when sunlight levels lower.
Inadequate intake of calcium and phosphorus in the diet can also lead to rickets. Rickets caused by a dietary lack of these minerals is rare in developed countries because calcium and phosphorus found in milk and green leafy vegetables.
Your genes may increase your risk of rickets. Hereditary rickets is a disease that is transmitted through families and occurs when the kidneys are unable to retain phosphorus. Rickets may also be caused by kidney disorders involving renal tubular acidosis.
Occasionally, rickets may also occur in children who have liver problems or can not convert vitamin D to its active form.
Rickets is rare in the United States. Most likely to occur during periods of rapid growth when the body demands high levels of calcium and phosphorus. It is usually seen in children 6 to 24 months of age and is uncommon in newborns.Symptoms
Bone pain or tenderness
arms
legs
column
pelvis
Skeletal deformities
bowlegged
forward projection of the breastbone (pigeon chest)
Bumps in the rib cage (rachitic rosary)
Skull asymmetrical or odd-shaped
spinal deformities (spine curves abnormally, including scoliosis or kyphosis)
Pelvic deformities
Increased tendency toward bone fractures
Dental deformities
Delayed formation of teeth
defects in the structure of teeth, holes in the enamel
increased incidence of tooth decay (dental caries)
progressive weakness
decreased muscle tone (loss of muscle strength)
Muscle cramps
Poor growth
Short stature adults within 1.52 m (5 ft) high
Signs and tests
A physical exam reveals tenderness or pain in the bones, rather than in the joints or muscles.
The following tests may help diagnose rickets:
Blood tests (serum calcium) may show low levels of calcium.
tetany (prolonged muscle spasm) which may occur if serum levels of calcium are low
Chvostek's sign may be positive (a spasm of facial muscles when facial nerve is tapped) indicating low serum calcium levels
Serum phosphorus may be low.
Serum alkaline phosphatase may be high.
Arterial blood gases may reveal metabolic acidosis.
X-rays of the bones may show loss of calcium from bones or changes in form or structure of these.
A bone biopsy is rarely performed but will confirm rickets.
Other tests and procedures include the following:
PTH
Urine calcium
Calcium (ionized)
Isoenzyme of ALP (alkaline phosphatase)
Treatment
The goal of treatment is to relieve symptoms and correct the cause of this condition. You must treat the underlying cause to prevent recurrence.
With the replacement of deficient calcium, phosphorus or vitamin D will eliminate most symptoms of rickets. Dietary sources of vitamin D include fish, liver and processed milk. It is recommended that exposure to moderate amounts of sunlight. Treating rickets caused by metabolic abnormalities may require a special prescription for vitamin D.
Good posture and the use of braces to help reduce or prevent deformities. In addition, you may need surgical correction of some skeletal deformities.Expectations (prognosis)
The disorder can be corrected with replacement of minerals and vitamin D deficient. Laboratory values and x-rays usually improve after almost a week of treatment, although some cases may be resistant and require large doses of minerals and vitamin D.
If rickets is not corrected while children are still growing, skeletal deformities and short stature may be permanent. Conversely, if it is corrected while the child is young, skeletal deformities often diminish or disappear over time.Complications
Chronic skeletal pain
Skeletal deformities
Skeletal fractures, may occur without cause
Calling your health care
Call your pediatrician if you notice symptoms of rickets.Prevention
Rickets may be avoided by having your child maintain an adequate intake of calcium, phosphorus and vitamin D. This may require dietary supplementation in people with gastrointestinal disorders or other conditions, which you should consult your pediatrician.
The renal causes of malabsorption of vitamin D should be treated promptly and levels of calcium and phosphorus should be monitored regularly in people with kidney disease.
Genetic counseling can help people with a family history of inherited disorders that can cause rickets.
source: clinicadam.com
