Two types of nutritional rickets in infants

Area of Science:

• Pediatric Endocrinology
• Nutritional Science
• Biochemistry

Background:

• Nutritional rickets is a common condition in infants.
• Vitamin D deficiency is a well-established cause of rickets.
• The roles of calcium and phosphorus in rickets pathogenesis require further elucidation.

Purpose of the Study:

• To investigate the relationship between serum mineral levels (calcium, phosphorus) and radiological signs of rickets in infants.
• To differentiate between vitamin D deficiency and primary phosphate deficiency as causes of rickets.

Main Methods:

• Studied 100 infants diagnosed with nutritional rickets.
• Assessed serum calcium and phosphorus levels.
• Evaluated serum alkaline phosphatase activity.
• Radiologically assessed bone lesions characteristic of rickets.

Main Results:

• A significant inverse correlation was observed between serum phosphorus levels and both serum alkaline phosphatase and radiological rickets severity.
• Serum calcium levels showed no correlation with the severity of bone lesions.
• Hypophosphatemia was identified as a typical biochemical feature of rickets in this cohort.

Conclusions:

• Hypophosphatemia, rather than hypocalcemia, is characteristic of nutritional rickets.
• The findings suggest two potential etiologies for rickets: true vitamin D deficiency (leading to hypocalcemia) and primary phosphate deficiency (leading to hypophosphatemia and rickets).
• A defect in phosphate transport may underlie primary phosphate deficiency rickets.