[Aspects of juvenile rickets/osteopenia in black children]

Area of Science:

• Pediatrics
• Nutritional Science
• Biochemistry

Background:

• Juvenile rickets and osteopenia in rural Black children are often attributed to low calcium intake.
• Typical biochemical findings include mild calcium deficiency, normal serum phosphate, elevated alkaline phosphatase, and normal vitamin D levels.

Purpose of the Study:

• To investigate the clinical and biochemical characteristics of juvenile rickets and osteopenia in a cohort of rural Black children.
• To assess treatment response and identify factors influencing outcomes in these patients.

Main Methods:

• A series of 62 Black children (average age 6.82 years) with suspected rickets or osteopenia were studied.
• Serum calcium, phosphate, alkaline phosphatase, and other electrolytes were measured.
• Radiological assessments and malabsorption evaluations were performed. Serum vitamin D levels were not determined.

Main Results:

• Low serum calcium was observed in 54% and hypophosphatemia in 29% of patients.
• Elevated alkaline phosphatase (>350 IU/l) was present in 61% of the children.
• All patients with hypophosphatemia improved, but 11 children showed no clear response to hospitalization, with 8 remaining hypocalcemic.

Conclusions:

• While hypophosphatemia responded to treatment, a significant subset of children with hypocalcemia or normal biochemistry did not show radiological improvement.
• The reasons for treatment non-response remain unclear, necessitating further investigation into optimal management strategies and the underlying pathophysiology.