A major health problem facing immigrant children: nutritional rickets.

Area of Science:

• Pediatric Endocrinology
• Nutritional Deficiencies
• Public Health

Background:

• Nutritional rickets (NR) remains a prevalent health concern, exacerbated by increasing immigrant populations.
• This study focuses on immigrant children diagnosed with NR in a pediatric endocrinology clinic.

Purpose of the Study:

• To evaluate cases of nutritional rickets in predominantly immigrant children.
• To understand the clinical presentation and biochemical markers of NR in this population.

Main Methods:

• Retrospective analysis of 20 pediatric cases diagnosed with NR between 2017 and 2020.
• Review of patient records for demographic data, biochemical parameters (calcium, phosphate, alkaline phosphatase, parathyroid hormone, 25-hydroxyvitamin D), and treatment outcomes.

Main Results:

• Eighty-five percent of the 20 included patients were immigrants.
• All patients had low 25-hydroxyvitamin D levels (<20 ng/mL); 17 had hypocalcemia and 13 had hypophosphatemia.
• Elevated parathyroid hormone (PTH) and alkaline phosphatase (ALP) were observed in most cases, indicating severe disease. Treatment with high-dose vitamin D led to improvement in 14 patients.

Conclusions:

• Elevated PTH levels suggest that only the most severe NR cases are seen in clinics, indicating a larger burden of subclinical disease.
• Public health strategies should prioritize universal vitamin D supplementation, adequate calcium intake, and integration into child surveillance programs.
• Informing families about risks and ensuring adequate nutrition, sunlight exposure, and support are crucial for both resident and immigrant children.