RICKETS
Rickets is a childhood disorder where bones soften and weakens and become prone to fractures and deformity, usually because of an extreme and prolonged vitamin D deficiency.
- Vitamin D is a fat-soluble vitamin that is essential for the normal formation of bones and teeth and promotes the absorption of calcium and phosphate from the intestine.
- A vitamin D deficiency makes it difficult for the body to maintain sufficient levels of calcium and phosphate.
- When this happens, the body produces a hormone that causes calcium and phosphate to be released from the bones.
- When the bone lacks these minerals, they become weak and soft.
- Vitamin D can be gotten from various food products such as milk, eggs, and fish.
- Rickets is common in the Middle East, Africa, and Asia and generally uncommon in the US and Europe.
- The condition affects both male and female equally and begins in childhood, typically between the ages of 3 and 18 months.
- If left untreated, rickets can lead to seizures, dental defects, failure to grow, or skeletal deformities.
Causes
The most common cause of rickets is vitamin D deficiency which is essential for strong and healthy bone development. Sources of Vitamin D include:
- Sunlight- sunlight, especially ultraviolet light. The skin produces Vitamin D when exposed to sunlight and we get most of our vitamin D this way. Children who spend fewer times outdoor or who uses sunscreen, which blocks the rays that trigger the skin’s production is more likely to develop rickets.
- Food- eggs, fish oils, some fortified breakfast cereals contain Vitamin D.
Maternal vitamin D deficiencies during pregnancy cause congenital rickets. This is due to a vitamin D deficiency in the mother’s blood which the baby shares. Other maternal diseases that can cause congenital rickets are:
- Untreated celiac disease
- Severe osteomalacia, which is the adult form of rickets
- Malabsorption
Genetic disorders causing soft bone in infants, such as
- Hypophosphatemia is a rare genetic disorder that causes abnormal development of bone and teeth. These abnormalities occur due to defective mineralization, the process by which bones and teeth take up minerals such as calcium or phosphate
- Hypophosphatemia which is a rare disorder caused by a chronically low level of phosphate in the blood caused by a genetic fault that prevents the kidneys from processing phosphates properly.
Some kidney, liver and intestinal disease can affect the way the body absorb vitamin D.
Factors that increase the risk of rickets may include:
- Premature birth
- Dark skin
- Breastfed infants who are exposed to little or no sunlight, or whose mothers are not exposed to sunlight.
- Any child whose diet does not contain vitamin D or calcium
- Exclusive breastfeeding without supplementation.
SYMPTOMS
- Delayed growth and short stature
- Muscle weakness
- Muscle weakness
- Skeletal deformities such as bowed legs or knock knees, protruding breastbone, curved spine, or thickened wrist or ankles.
- Teeth deformities such as delayed tooth formation, abscesses, defects in the tooth structure.
DIAGNOSIS AND TREATMENT
The doctor may be able to diagnose rickets by performing a physical examination. The doctor will gently press on the child’s bones, checking for deformities. The doctor will pay close attention to the child’s skull, legs, chest, wrists, and ankles.
To help with diagnosis, the doctor may order blood and urine test to measure the level of calcium and phosphate in the blood and also bone x-ray to reveal bone deformities.
TREATMENT
The aim of treatment is to replace the missing vitamin or mineral in the body which will eliminate most of the symptoms associated with rickets.
For children with vitamin D deficiency, the doctor may suggest increased exposure to sunlight as well as consuming food products high in vitamin D such as fish, milk, and eggs.
Calcium and vitamin D supplement may also be used in treating rickets.
For genetic disorders, a combination of phosphate supplements and high levels of a special form of vitamin D are required.
If skeletal deformities are present. The child may need special bracing that helps position their bones correctly as they grow. In severe cases, the child may need corrective surgery.