A retrospective evaluation of patients with rickets

Abstract

Introduction: Rickets is a group of diseases presenting with skeletal deformities and decreased growth rate due to diminished epiphyseal calcification. It has been previously reported that in our country, nutritional rickets with Vitamin D insufficiency is an important healthcare problem.Material and Method: In this study, we have evaluated 20 patients with rickets being followed up in pediatric endocrinology outpatient clinic of Uludag University between 2006 and 2010. The diagnosis of nutritional rickets was defined with positive response to treatment and hypocalcaemia accompanied by one of the followings; rickets specific radiological changes, high alkaline phosphates levels or low Vitamin D levels. p<0.05 is accepted as statistically significant. The statistical analysis was performed using SPSS 16.0.Results: A total of 14 boys and 6 girls were included in this study. Ten of the patients were considered as nutritional rickets, 5 were hypophosphatemic rickets and 5 were vitamin D dependent rickets type 1. On radiological evaluation, distal metaphyseal enlargement-irregularity of radius and ulna was found in 11 patients. O-bain deformity was seen in 3 patients. Ten of the patients were from small districts, 5 were from villages and the remainders were from city center. The main complaints were short stature in 5 patients, difficulty in walking in 4 patients, recurrent pneumonia in 4 patients, seizure in 4 patients, bone deformity in 3 patients, tetany in 2 patients, and ballismus in one patient.Discussion: Rickets is still a major health problem in childhood. It must be kept in mind in the patients who have short stature and difficulty in walking. Vitamin D dependent rickets or hypophosphatemic rickets must be considered in the patients who have signs and symptoms of rickets in spite of regular vitamin D supplementation. These patients should be referred to a pediatric endocrinologist.