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[Bone and joint diseases in children. Rickets]

Hiroyuki Tanaka1

  • 1Department of Pediatrics, Okayama Saiseikai General Hospital.

Clinical Calcium
|June 2, 2010
PubMed

Insights

Rickets involves growth plate defects, often due to low phosphate. This review covers vitamin D deficiency rickets and hereditary hypophosphatemic rickets, highlighting recent advances in understanding phosphate metabolism.

Area of Science:

  • Pediatric Endocrinology
  • Skeletal Biology
  • Mineral Metabolism

Background:

  • Rickets is a disorder affecting growth plate chondrocytes.
  • Pathophysiology involves defective apoptosis of hypertrophic chondrocytes due to low body fluid phosphate.
  • Environmental changes contribute to the resurgence of vitamin D deficient rickets.

Purpose of the Study:

  • To review recent advancements in the understanding of two major forms of rickets: vitamin D deficient rickets and hereditary hypophosphatemic rickets.
  • To highlight the increasing knowledge of hereditary hypophosphatemic rickets pathophysiology following the discovery of fibroblast growth factor 23.
  • To explore the implications of these findings for understanding phosphate metabolism.

Main Methods:

  • Literature review of recent research on rickets.
  • Focus on vitamin D deficient rickets and hereditary hypophosphatemic rickets.
  • Analysis of studies related to fibroblast growth factor 23 and gene discovery.

Main Results:

  • Vitamin D deficient rickets is re-emerging globally due to environmental factors.
  • Significant progress has been made in understanding the pathophysiology of hereditary hypophosphatemic rickets.
  • Discovery of fibroblast growth factor 23 and responsible genes has advanced knowledge of phosphate metabolism.

Conclusions:

  • Rickets pathophysiology is linked to chondrocyte apoptosis and phosphate levels.
  • Environmental factors play a role in the prevalence of vitamin D deficient rickets.
  • Advances in understanding fibroblast growth factor 23 offer new insights into phosphate metabolism and hereditary hypophosphatemic rickets.

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