Rickets in the New Age of Food Allergies: A Case Report and Comprehensive Review

Area of Science:

• Pediatric Endocrinology
• Nutritional Science
• Orthopedics

Background:

• Nutritional rickets, a disorder of defective bone mineralization, is reemerging in pediatric populations.
• Common food allergens like dairy, eggs, and fish are primary vitamin D sources, increasing risk for allergic children.
• Children with multiple food allergies and restricted diets are at heightened risk for vitamin D deficiency.

Purpose of the Study:

• To report a case of vitamin D-deficient rickets in a pediatric patient with multiple food allergies.
• To highlight the link between food allergies, restricted diets, and metabolic bone disease.
• To emphasize the need for increased awareness and timely intervention.

Main Methods:

• A case report of a 2-year-old male with multiple food allergies presenting with leg deformities.
• Radiographic evaluation showing characteristic rickets findings.
• Laboratory tests confirming severe vitamin D deficiency (4 ng/mL) and impaired bone mineralization.

Main Results:

• The patient exhibited progressive bilateral leg bowing consistent with rickets.
• Biochemical profile revealed low calcium and phosphorus, elevated alkaline phosphatase, and critically low vitamin D.
• Treatment initiated with high-dose vitamin D (6000 IU/day) and dietary counseling.

Conclusions:

• This case underscores the intersection of pediatric metabolic bone disease and food allergies.
• Heightened awareness of nutritional deficiencies is essential in children with restricted diets.
• Early diagnosis, supplementation, and interdisciplinary management are critical for vitamin D-deficient rickets.