Rickets and its causes and treatment
Rickets means twisted. The bones become twisted and deformed in rickets. Rickets is a disorder of growing bones due to defective mineralization of the bone matrix at the growth plates in children before the fusion of epiphysis.
Pathophysiology of Rickets
Defective mineralization of bone matrix at growth rates. As a result, the growth plate cartilage and the osteoid that is the matrix continue to expand. Mineralization is inadequate. When bones don’t get mineralized properly:
They get soft so there will be more deformities and fractures
Bones width increase at growth plates and distal end of metaphysis. Wrist widening occur.
Causes
Most common cause of rickets is nutritional deficiency of Vitamin D. On etiological basis, we can divide the rickets into:
Nutritional Rickets
Refractory Rickets
Most common causes of rickets include
- Vitamin D deficiency
- Calcium deficiency
- Phosphorus deficiency
Nutritional Rickets
Nutritional rickets may be due to vitamin D, calcium and phosphate deficiency. Vitamin D deficiency also occur due to congenital deficiency and poor diet intake. Individual is taking vitamin D in diet but it is not properly absorbed into the body due to malabsorption. Liver and kidney disease also affect vitamin D absorption.
Refractory Rickets
Refractory rickets are difficult to treat. It does not respond to the usual treatment of nutritional rickets. It include VDDR vitamin D dependent rickets type1 and type 2. Chronic kidney disease also give rise to refractory disease. This is not caused by vitamin D deficiency.
Symptoms of Rickets
- Weight loss
- Respiratory infections
- Failure to thrive
- Softening of ribs
- Increased risk of failure
- Bone pain
- Muscle spasm
- Dental carries
- Large forehead
- Stunted growth
Diagnosis
Blood testing is recommended to find low calcium, low phosphorus levels. X ray is also recommended sometimes.
Treatment
Vitamin D supplementation helps to raise blood levels, reduce bone loss, improve muscle performance and lower risk of fractures.
The widespread use of vitamin D fortified milk had nearly eliminated rickets, but the disease is making a comeback among breastfed infants who do not receive vitamin D supplementation. Breast milk is generally low in vitamin D, so among mothers with poor vitamin D status.
To know how to balance diet that is enriched in all nutrients please visit:
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