VITAMIN D DEFICIENCY RICKETS – A CASE SERIES

A TIP OF THE ICEBERG

Authors

  • Naveen N Hospital Tuanku Ja’afar Seremban, Malaysia
  • Jeanne WSL Hospital Putrajaya, Malaysia
  • Cheah YK Hospital Tuanku Ja’afar Seremban, Malaysia

DOI:

https://doi.org/10.15605/jafes.036.S96

Keywords:

vitamin d, deficiency

Abstract

INTRODUCTION
Vitamin D deficiency is the most common cause of rickets worldwide. In Malaysia, owing to the abundant sunlight exposure, it is believed to be uncommon, however it is likely to be under-reported. In addition, dietary calcium deficiency is an important cause of nutritional rickets in children above 1 year old in developing countries.

RESULTS
We report a case-series of 4 unrelated Malaysian children (aged between 1 to 3) born in Istanbul, Turkey presented with the classical clinical features and biochemical changes of rickets. They were all exclusively breast-fed during infancy with poor dietary calcium intake. Their workup showed normal Calcium, high Alkaline Phosphatase, low Vitamin D and high Parathyroid hormone levels, with radiographic changes of fraying and spraying of the wrist, consistent with Vitamin D Deficiency Rickets. Bowing of legs and widening of wrists joints also seen. Low maternal Vitamin D levels also support the diagnosis. All four children were treated with cholecalciferol (vitamin D3) and short-term calcium supplements. The children showed improvements in growth and normalization of biochemical parameters on follow-ups.

CONCLUSION
Meta-analysis in Turkish populations have shown high prevalence of Vitamin D deficiency leading to their national policy of vitamin D supplementation for infants. Our patients in this case series were neither immunized nor received the appropriate supplements during their stay in Istanbul, Turkey. Maternal vitamin D deficiency, restricted sunlight exposure due to clothing style and seasonal variations, poor dietary calcium intake were all the contributing factors to the nutritional rickets in our patients. Maternal Vitamin D levels could serve as an early indicator of possible deficiency if detected early. Awareness amongst our population was scarce, leading to a delay in seeking treatment/intervention. This case series aims to highlight the importance of vitamin D supplementation as well as ensuring adequate dietary
calcium in prevention of nutritional rickets

Downloads

Download data is not yet available.

Author Biographies

Naveen N, Hospital Tuanku Ja’afar Seremban, Malaysia

Department of Paediatrics

Jeanne WSL, Hospital Putrajaya, Malaysia

Department of Paediatrics

Cheah YK, Hospital Tuanku Ja’afar Seremban, Malaysia

Department of Paediatrics,

References

*

Published

2021-07-28

How to Cite

N, N. ., WSL, J. ., & YK, C. . (2021). VITAMIN D DEFICIENCY RICKETS – A CASE SERIES: A TIP OF THE ICEBERG. Journal of the ASEAN Federation of Endocrine Societies, 36, 64. https://doi.org/10.15605/jafes.036.S96

Issue

Section

Abstracts for Poster Presentation | Paediatric