[Symptomatic hypocalcaemia due to nutritional rickets. A presentation of two cases]

The nutritional rickets is considered an uncommon disease in developed countries, but the increase in its incidence appears to be related to the increase in the number of immigrants in these countries. Thus in Spain, we must increase our diagnostic suspicion of this disease and be able to detect it, even when it appears with unusual symptoms. We describe two clinical cases of breast-fed babies who presented with symptomatic hypocalcaemia and were diagnosed with rickets. Case 1. A six month-old breast-fed baby who had episodes of tonic seizures and irritability, with no other findings in the physical examination, and diagnosed with secondary hypocalcaemia due to nutritional rickets. Case 2. A seven month-old breast-fed baby who had generalised hypertonia, stridor and irritability, with a normal physical examination, and also diagnosed with hypocalcaemia secondary to rickets.

The old concept that rickets is a rare condition in our country means that we often tend to rule out this pathology, thus delaying the diagnosis and the treatment. We must review our concepts in order to be able to detect the common and also the unusual symptoms of nutritional rickets.