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Unusual Complications of Rickets

Source: www.indianpediatrics.net
Topic: Rickets
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Sort Desciption: Hypocalcemia occurs when the homeostatic mechanisms responsible for the maintenance of physiological serum concentrations of ionized calcium fail. ...

Content Inside:
Hypocalcemia occurs when the homeostatic mechanisms responsible for the maintenance of physiological serum concentrations of ionized calcium fail. Hypocalcemia whether transient, acute or chronic, should be regarded as a sign only; therefore, an underlying pathophysiology should be sought at the same time that the treatment is initiated for all but the mildest symptoms(l).

We describe an interesting case of rickets associated hypocalcemia manifesting as seizures and later high dose Vitamin D therapy to the child leading to coma and cardiac tetany (hungry bone phenomenon)(2). The case is presented because after extensive search of literature and to the best of our knowledge a similar presentation could not be found.

Case Report

A one-year-old female Muslim child weighing 8 kg presented with fever, cough and respiratory distress since 8 days with 6 episodes of convulsions of generalized tonic-clonic type since one day. Between convulsions, the child was irritable without impairment of consciousness. There was a past history of six episodes of generalized tonic-clonic convulsions not associated with fever since the age of seven months, the frequency of which had increased since the last one month, in which the child had four episodes. The child was receiving anticonvulsant carbamazepine in inadequate dose with no response. The developmental and natal history was normal; however, the child had been exclusively breastfed with no weaning. On examination, the child had evidence of anemia and rickets and the neurological examination was normal.

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