Abstract:
Aim. To describe the characteristics of children with
vitamin D deficiency rickets and identify common features
and predisposing factors.
Methods. A review of the clinical notes of all children less
than five years of age with radiological evidence of rickets
and serum 25-hydroxyvitamin D levels of less than
10 μg/L. Patients were identified by searching all low
vitamin D levels performed at the Endocrinology
laboratory at Auckland Hospital and children presenting to
the Starship Childrens’ Hospital with rickets in 1998.
Results. In 1998, there were eighteen children (ten males
and eight females) with vitamin D deficient rickets. The
age range was 3 to 36 months with a median of 12 months.
There were twelve children of Indian ethnic origin, one
Maori, one Tongan, one Western Samoan, one Ethiopian,
one Moroccan and one Indonesian. All children had an
elevated alkaline phosphatase level and most had very low
serum 25-hydroxyvitamin D levels (≤5 μg/L), and over half
were hypocalcaemic. The common presenting features
were delayed walking and bowed legs, swollen wrists or
ankles, hypocalcaemic seizure, incidental radiological
abnormalities and failure to thrive.
Conclusions. There are a significant number of children
in Auckland presenting with florid clinical rickets. The
majority with vitamin D deficient rickets in this survey
were of Indian ethnic origin. Strategies are needed to
detect children at risk of vitamin D deficiency and
supplement them with vitamin D.