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Unique form of rickets with low serum 25‐hydroxyvitamin D in two normally nourished children
Author(s) -
ASAMI TADASHI,
KAWASAKI TAKUYA,
UCHIYAMA MAKOTO
Publication year - 1995
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.1995.tb03294.x
Subject(s) - rickets , medicine , vitamin d and neurology , alkaline phosphatase , endocrinology , vitamin d deficiency , ergocalciferol , pediatrics , gastroenterology , cholecalciferol , biochemistry , chemistry , enzyme
Abstract We present an unusual type of rickets involving two children: a 2 year old boy and a 15 month old boy, who presented with marked bowing of the lower extremities and bulging of costochondral junctions. Both children had normal growth, with their height and body weight greater than the 50th and 97th percentile for age. Roentgenograms of their extremities showed the typical changes of vitamin D refractory rickets. Serum alkaline phosphatase levels were elevated and serum levels of calcium and phosphate were both within the normal range. No primary cause for the rickets, including nutritional deficiencies, was found in the two patients. Characteristic findings were persistently low serum 25‐hydroxyvitamin D (25‐OH‐D) and normal 1,25‐dihydroxyvitamin D (1,25‐(OH)2‐D). Improvements in clinical and X‐ray findings were observed after either oral administration of 1 α‐(OH)‐D3 (9–15 μg per day) or massive vitamin D2 therapy (600 000 IU single injection). The low serum levels of 25‐OH‐D did not increase unless massive vitamin D2 therapy was also given. These two cases represent a unique form of rickets that does not meet the criteria for any type of previously known rickets.