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Variable presentations of rickets in children in the emergency department

Erete Bloom1, Eileen J Klein, Denise Shushan

  • 1Department of Pediatrics, University of Washington and Children's Hospital and Regional Medical Center, Seattle, WA.

Pediatric Emergency Care
|February 6, 2004
PubMed

Insights

Vitamin D-deficient rickets, though uncommon, is increasing in children, often presenting with fractures or seizures. Prompt diagnosis and treatment of nutritional rickets are crucial for symptom resolution.

Area of Science:

  • Pediatrics
  • Nutritional Science
  • Endocrinology

Background:

  • Nutritional rickets due to vitamin D deficiency is increasingly recognized in pediatric populations.
  • The rise may be linked to increased rates of breastfeeding, which can be low in vitamin D.
  • Rickets should be considered in various clinical scenarios presenting with specific symptoms.

Observation:

  • Three pediatric cases of rickets presenting to the emergency department are detailed.
  • Presentations included fractures (initially concerning for abuse), tetany, and hypocalcemic seizures.
  • These acute symptoms were directly related to underlying rickets.

Findings:

  • Laboratory and radiographic evaluations confirmed nutritional rickets in all presented cases.
  • Symptoms, including fractures and seizures, resolved effectively with appropriate vitamin D treatment.
  • The clinical presentations highlighted the diverse and sometimes severe manifestations of vitamin D deficiency.

Implications:

  • Clinicians should maintain a high index of suspicion for vitamin D-deficient rickets in children with concerning presentations.
  • Early recognition and management are vital to prevent severe complications and ensure recovery.
  • Public health awareness regarding vitamin D sources and supplementation may be warranted.

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