Open AccessRaquitismo: Ressurgimento do Passado
Author(s) -
Margarida Valério,
Sara Pimentel Marcos,
Conceição Santos,
Maria João Leiria
Publication year - 2015
Publication title -
acta médica portuguesa
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.316
H-Index - 21
eISSN - 1646-0758
pISSN - 0870-399X
DOI - 10.20344/amp.5520
Subject(s) - rickets , parathyroid hormone , medicine , vitamin d and neurology , endocrinology , gynecology , calcium
In the past decade rickets has re-emerged in developed countries due to changes in lifestyles and dietary habits. We describe a case of a 28-month-old black infant with failure to thrive. He was exclusively breastfed until nine months of age, without vitamin supplementation, and never ingested milk products due to alleged cow’s milk intolerance. His examination revealed bowlegs, rachitic rosary and wide wrists. Alkaline phosphatase and intact parathyroid hormone levels were elevated, and calcidiol was decreased. Radiographic images showed bone demineralization, fraying and cupping of the distal radius and ulna. Nutritional rickets was considered and treatment with colecalciferol and calcium carbonate was initiated, with clinical, laboratory and radiologic improvement. In this case, a group of factors contributed to severe nutritional rickets, alerting to the re-emergence of this disease.