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An Electroporation Method to Transform Rickettsia spp. with a Fluorescent Protein-Expressing Shuttle Vector in Tick Cell Lines
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[Rickets: Emerging From the Past].

Margarida Valério1, Sara Pimentel Marcos1, Conceição Santos1

  • 1Serviço de Pediatria. Hospital de São Francisco Xavier. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal.

Acta Medica Portuguesa
|June 11, 2015
PubMed
Summary

Nutritional rickets is re-emerging in developed countries. This case highlights how exclusive breastfeeding without vitamin D supplementation can lead to severe rickets in infants.

Area of Science:

  • Pediatrics
  • Nutritional Science
  • Public Health

Background:

  • Rickets has seen a resurgence in developed nations, linked to evolving lifestyles and dietary patterns.
  • Nutritional rickets, particularly in infants, is a growing concern due to inadequate vitamin D intake.
  • Exclusive breastfeeding, while beneficial, necessitates vitamin D supplementation to prevent deficiencies.

Observation:

  • A 28-month-old infant presented with failure to thrive, bowlegs, rachitic rosary, and wide wrists.
  • The infant was exclusively breastfed for nine months without vitamin supplementation and avoided milk products.
  • Clinical examination revealed characteristic signs of rickets, supported by laboratory and radiographic evidence.

Findings:

  • Elevated alkaline phosphatase and intact parathyroid hormone levels, with decreased calcidiol, indicated vitamin D deficiency.

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  • Radiographic imaging confirmed bone demineralization and characteristic rachitic changes in the distal radius and ulna.
  • Nutritional rickets was diagnosed, prompting treatment with colecalciferol and calcium carbonate.

    • Implications:

    • This case underscores the critical role of vitamin D supplementation in exclusively breastfed infants.
    • The findings alert healthcare providers to the increasing prevalence of nutritional rickets in developed countries.
    • Early diagnosis and intervention are crucial for managing and preventing long-term skeletal complications of rickets.