Clinical Insights Concerning Rickets in Association With Neurodevelopmental Disorders: A Systematic Review Focused on Autism.

Abstract

This systematic review examines the intersection of rickets and autism spectrum disorder (ASD), highlighting clinical insights from 10 studies involving 13 patients. Rickets, a pediatric bone disorder resulting from vitamin D, calcium, and/or phosphate deficiencies, often manifests through skeletal deformities, muscle weakness, and bone pain. ASD is a neurodevelopmental condition characterized by deficits in social communication and repetitive behaviors. The coexistence of these conditions, although uncommon, is notable due to overlapping factors such as selective eating habits and sensory sensitivities in children with ASD, which may exacerbate nutritional deficiencies. A comprehensive search across PubMed, Google Scholar, and Web of Science identified 65 relevant articles meeting the initial inclusion criteria, 10 of which (reporting on 13 patients) met the final review criteria for inclusion. All patients exhibited food selectivity, with most excluding dairy products and favoring potato-based foods. Musculoskeletal symptoms were predominant, with genu valgum, wrist widening, and metaphysis fraying being common findings. Seizures were the second most frequent reason for hospital admission, emphasizing the importance of monitoring neurological health in these patients. Calcium supplementation, primarily with calcium carbonate or calcium gluconate, was used in all cases, and the majority of patients experienced normalization of biochemical markers, including serum calcium levels. This review underscores the need for interdisciplinary care, focusing on nutritional and behavioral interventions to manage both rickets and ASD effectively. Future research should aim to explore larger and more diverse populations to better understand the clinical interplay between these conditions and inform more comprehensive treatment strategies.