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Vitamin D-deficient rickets: a multifactorial disease.

S Fitzpatrick¹, N F Sheard, N G Clark

¹Department of Nutrition and Food Sciences, University of Vermont, Burlington 05401, USA.

Nutrition Reviews

|August 15, 2000

Summary

A breast-fed African-American child developed vitamin D-deficient rickets due to limited sun exposure in New England. Prompt vitamin D supplementation effectively treated the condition, highlighting the importance of monitoring and intervention.

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Area of Science:

Pediatrics
Nutritional Science
Public Health

Background:

Nutritional rickets is a significant concern in infants and children, particularly those with limited sun exposure.
Breastfeeding, while beneficial, may require vitamin D supplementation to meet infant needs, especially in northern latitudes.
Geographic location and limited ultraviolet (UV) light exposure are critical factors in vitamin D synthesis.

Observation:

An African-American infant exclusively breast-fed for one year presented with classic signs of nutritional rickets.
The child resided in New England, a region with reduced UV light availability due to its northern latitude and prolonged winters.
Clinical presentation included symptoms indicative of vitamin D deficiency, such as bone pain and deformities.

Findings:

The case demonstrates a clear link between exclusive breastfeeding, insufficient vitamin D intake, and the development of rickets.
Limited seasonal and geographic UV light exposure exacerbated the risk of vitamin D deficiency in this patient.
The child showed a rapid and positive response to oral vitamin D supplementation.

Implications:

This case underscores the importance of vitamin D screening and supplementation for breast-fed infants, especially in at-risk populations.
Public health initiatives should emphasize vitamin D adequacy for infants in regions with limited sunlight.
Early diagnosis and appropriate supplementation are crucial for preventing long-term skeletal complications associated with rickets.