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Arch Pediatr Adolesc Med. 2006;160:984-985.

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Denouement and Discussion: Nutritional Rickets

Nutritional rickets has a prevalence rate between 5% and 10% in developing countries.^1-2 By the mid 1900s, nutritional rickets was virtually eliminated in the United States. However, a recent reemergence has been witnessed by health care providers in the United States and other developed countries.^3-6 Because rickets is not a reportable disease, the exact incidence in US children is unknown.

Rickets occurs when calcium and/or phosphorus deficiency results in inadequate bone mineralization. Both 1,25-dihydroxyvitamin D and parathyroid hormone are essential to calcium and phosphorus homeostasis. The 1,25-dihydroxyvitamin D increases calcium and phosphorus absorption from the gastrointestinal tract. Parathyroid hormone increases the serum calcium level by bone resorption and decreases the serum phosphorus level by increased urinary excretion. Together, these mechanisms maintain serum calcium and phosphorus concentrations at the expense of bone mineralization.⁷ Rickets occurs in patients with disorders in calcium, phosphorus, and vitamin D metabolism.

Nutritional rickets occurs when 1,25-dihydroxyvitamin . . . [Full Text of this Article]

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