Radiological and biochemical resolution of nutritional rickets with calcium

Area of Science:

• Pediatrics
• Nutritional Science
• Biochemistry

Background:

• Rickets is a significant skeletal disorder in children, particularly prevalent in regions with limited sunlight exposure and dietary calcium intake.
• Understanding the efficacy of simple supplementation is crucial for public health interventions in affected populations.

Purpose of the Study:

• To evaluate the therapeutic response to oral calcium supplementation in Nigerian children diagnosed with rickets.
• To assess both clinical and biochemical markers of healing following calcium treatment.

Main Methods:

• A cohort of 26 Nigerian children (aged 2-5 years) with confirmed rickets received daily oral calcium lactate (2.7 g).
• Clinical improvement was monitored through symptom relief and activity levels.
• Radiological scoring and biochemical parameters (alkaline phosphatase, 1,25-dihydroxyvitamin D, calcium, parathyroid hormone, and collagen cross-linked telopeptide) were assessed over six months.

Main Results:

• Significant improvement in radiological scores from a mean of 3.3 to 0.9 over six months, with 12 cases achieving radiological healing.
• Marked reduction in plasma alkaline phosphatase and 1,25-dihydroxyvitamin D levels, alongside a decrease in parathyroid hormone.
• Clinical benefits included relief of leg pain and increased activity within one month of treatment.

Conclusions:

• Oral calcium supplementation alone demonstrated significant efficacy in healing rickets in the majority of Nigerian children studied.
• Calcium therapy may represent a sufficient and accessible treatment strategy for rickets in this specific geographical and nutritional context.