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rickets: not a disease of the past


image: rickets: not a disease of the past

Source: www.aafp.org
Topic: Rickets
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Sort Desciption: Other causes of rickets include renal disease, medications, and malabsorption syndromes. ... rickets with hypercalciuria is treated with phosphorus alone. ...

Content Inside:
The mother of a 26-month-old black infant expresses concern that her son is not growing properly. Born at 34 weeks of gestation at 3 lb, 5 oz (1.5 kg), he was exclusively breastfed until 11 months of age. He is a picky eater, is breastfed twice daily, and consumes minimal dairy products. His examination reveals a weight of 21 lb (9.6 kg; below the fifth percentile for age), height of 72.5 cm (below the fifth percentile), and head circumference of 74.5 cm (50th percentile). Other abnormal findings include frontal bossing, open anterior fontanel, wide wrists, and bowlegs. Nutritional rickets is suspected and confirmed with laboratory and radiographic evaluations. Levels of serum alkaline phosphatase and parathyroid hormone are elevated, and calcidiol (25 OH D 3 ) is decreased. Radiographic images of the wrist show fraying and cupping of the distal radius and ulna, as well as bone demineralization. Treatment is initiated with oral solution of ergocalciferol at 4,000 IU per day for six weeks with close monitoring of calcium and phosphorus levels. Introduction Rickets is not a disease ...

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