Abstract
Objective: Nutritional rickets continues to be an important health care problem. Its incidence has decreased in our country following the free vitamin D distribution that started in 2005 but it continues to stay on the agenda as a preventable disorder. Our aim was to evaluate patients diagnosed with nutritional rickets following the vitamin D supplementation program.
Material and Methods: A total of 93 cases diagnosed with nutritional rickets were included in the study. The data were retrospectively collected from patient records and laboratory analyses.results: The 93 nutritional rickets patients we evaluated consisted of 39 (41%) girls and 54 (59%) boys. The mean age was 19.1±35.1 months. The physical examination usually revealed widening of the wrists and rachitic beads. The most common sign at presentation was hypocalcemic seizure (28%, n= 26). Hypocalcemia was present in 46% (n= 43) and single large doses of vitamin D (stoss) therapy had been administered to 53% (n= 49). A concurrent disorder was present in 46%. The patients had presented mostly in February and May and only 20% had been receiving vitamin D supplementation. conclusion: The 400 IU vitamin D supplementation dose needs to be revised and the program made more widely available
Keywords: Child, Nutritional rickets, Vitamin D
References
- Pitt MJ. Rickets and osteomalacia are still around. Radiol Clin North Am 1991;29:97-118.
- Prentice A. Nutritional rickets around the world. J Steroid Biochem Mol Biol 2013;136:201-6.
- Hatun S. Vitamin D deficiency and prevention: Turkish experience. J Pediatr Sci 2012;8:4-8.
- Akpede GO, Omotara BA, Ambe JP. Rickets and deprivation: A Nigerian study. J R Soc Promot Health 1999;119:216-22.
- Evaluation of the vitamin D intake history of our patients revealed that only 20% were taking vitamin D regularly, meaning that 80%
- Ladhani S, Srinivasan L, Buchanan C, Allgrove J. Presentation of vitamin D deficiency. Arch Dis Child 2004;89:781-4.
- Hatun S, Ozkan B, Orbak Z, Doneray H, Cizmecioglu F, Toprak D, et al. Vitamin D deficiency in early infancy. J Nutr 2005;135: 279- 82.
- Wharton B, Bishop N. Rickets. Lancet 2003;25:1389-400.
- Ward LM, Gaboury I, Ladhani M, Zlotkin S. Vitamin D-deficiency rickets among children in Canada. CMAJ 2007;177:161-6.
- Cesur Y. Nutritional rickets. J Pediatr Sci 2012;8:33-41.
- Doğan M, Erol M, Cesur Y, Yuca SA, Dogan SZ. The effect of 25-hydroxyvitamin D3 on the immune system. J Pediatr Endocrinol Metab 2009;22:929-35.
- Haider N, Nagie A. Frequency of nutritional rickets in children admitted with severe pneumonia. J Pak Med Assoc 2010;60:729- 32.
- McNally JD, Leis K, Matheson LA, Karuananyake C, Sankaran K, Rosenberg AM. Vitamin D deficiency in young children with severe acute lower respiratory infection. Pediatr Pulmonol 2009;44:981- 8.
- Doğan M, Erol M, Cesur Y, Yuca SA, Doğan Z. The effect of 25-hydroxyvitamin D on the immune system. J Pediatr Endocrinol Metab 2009;22:929-35.
- Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc 2006;81:353-73.
- Mutlu G, Kusdal Y. Prevention of vitamin D deficiency in infancy: Daily 400 İU vitamin D is sufficient. Int J Pediatr Endocrinol 2011;2011:4.
- Agarwal KS, Mughal MZ, Upadhyay P, Berry JL, Mawer EB, Puliyel JM. The impact of atmospheric pollution on vitamin D status of infants and toddlers in Delhi, India. Arch Dis Child 2002;87:111-3.
- Salama MM, El-Sakka AS. Hypocalcemic seizures in breastfed infants with rickets secondary to severe maternal vitamin D deficiency. Pak J Biol Sci 2010;13:437-42.
