Management of a child with rickets

Author Martina LazărCoauthor Anca Liana LeucaCoordinator Assistant Professor Zsuzsanna Gall

Introduction

• Rickets is a disease of growing bone that is unique to children and teenagers. It is caused by a failure of osteoid to calcify in a growing person.

Introduction

• Vitamin D is a key hormone in the regulation of calcium and phosphorus metabolism and plays a principal role in bone health, particularly during pediatric age when nutritional rickets and impaired bone mass acquisition may occur.

Ethiology

• There are many causes of rickets, including – vitamin D deficiency, inadecvated diet, – calcium deficiency, – phosphorous deficiency, – distal renal tubular acidosis, – insufficient exposure to UV, and – medications.

Purpose

The purpose of this study is to evaluate the patient with rickets

depending on epidemiological,

clinical and paraclinical data .

Material and Methods

This is a retrospective study over a period of two years, on a group of 105 children of different ages diagnosed with rickets and hospitalized in 2nd Pediatric Department in Targu-Mures, between January 2013 and December 2014.

Results

• Provenience– The majority of the patients were from rural

area.

Results

• The rickets affected predominantly males.

Results• Although more studies showed, that prematurity and low

weight at born are predisposing factors, in our study, they were present in 11,43%, respectively 12,38% .

Results

• Corresponding to the data from the specialty literature, majority of affected children were newborns, infants and young children. The average age of the patients was 1 year and 4 months in my study.

Results

• Hypotrophy and distrophy stature-weight are another contributing factors for rickets. In the study group, only 12,4% of children present hypotrophy and 8,6% distrophy.

Results

• Associated diagnosis

Clinical features

• Frontal bossing, kyphosis, enlargement of wrist, depressed ribs

Clinical features

• Harrison groove

• Rachitic rosary

• Delayed dentition

Conclusion

• After processing the data, we obtained the following results: – the rickets affected 62,86% of boys, – referring to the environment, 64.8% were originated

from rural area, – prematurity was present in 11,43% and low weight

at born in 12,38% of cases. – 21% of children present hypotrophy and distrophy

and majority of children presents associated diagnosis.

Conclusion

• This study in 2nd Pediatric Department in Targu-Mures has shown that all these favoring factors were not statistically significant . By interpretating this results we have reached the conclusion that the administration of vitamine D was incorectly efectuated in most of the patients.

• Rickets is a very common disease, although exists an accessible and affordable prevention mode. The rickets can be associated with other diseases, some of them with severe prognosis. 

Prevention

• The most effective ways of prophylaxy are:– Sun exposure– Aerotherapy– Variate alimentation – Administation of calcium and– vitamine D

The best treatment is prevention.

Thank you!