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Vitamin D deficiency rickets at birth in Kuwait
1Department of Paediatrics, Ahmadi Hospital, Kuwait.
Insights
This study found that newborns can be born with vitamin D deficiency rickets, characterized by rachitic rosary. Early diagnosis is crucial as biochemical markers like low 25-hydroxyvitamin D and high alkaline phosphatase are common in affected infants.
Area of Science:
- Neonatology
- Pediatric Endocrinology
- Nutritional Science
Background:
- Vitamin D deficiency rickets is a significant concern in newborns.
- Rachitic rosary at birth indicates potential underlying deficiencies.
Purpose of the Study:
- To investigate the incidence and characteristics of vitamin D deficiency rickets in newborns diagnosed within 24 hours of birth.
- To evaluate biochemical and radiological markers associated with early-onset rickets.
Main Methods:
- Study included seventy-five full-term newborns presenting with rachitic rosary within 24 hours of birth.
- Measured 25-hydroxyvitamin D, alkaline phosphatase, and phosphate levels.
- Assessed radiological changes suggestive of rickets via wrist X-rays.
- Analyzed 1,25 dihydroxyvitamin D in a subset of infants.
Main Results:
- 56 out of 75 newborns and 15 mothers had low 25-hydroxyvitamin D levels.
- 26 newborns exhibited elevated alkaline phosphatase.
- Only 14 newborns showed radiological signs of rickets.
- Hyperphosphataemia was detected in all newborns.
- 1,25 dihydroxyvitamin D was markedly increased in 6 of 10 tested newborns.
Conclusions:
- Newborns can present with vitamin D deficiency rickets shortly after birth.
- Biochemical markers are more sensitive than radiological findings in early diagnosis.
- Further investigation into the role of 1,25 dihydroxyvitamin D in neonatal rickets is warranted.
Abstract:
In the present study vitamin D deficiency rickets has been diagnosed within 24 hrs. of birth. Seventy five full term, otherwise healthy newborns, weighing more than 2.5 kg were born with rachitic rosary. 25-Hydroxyvitamin D was lower than normal in 56 newborns and 15 mothers. Alkaline phosphatase was higher than normal in 26 and radiological changes suggestive of rickets were seen in the wrist X ray of only 14 newborns. Hyperphosphataemia was present in all the newborns. 1,25 dihydroxyvitamin D was markedly increased in six out of ten newborns.