Characteristics of rickets in a referral hospital in Khartoum-Sudan

Abstract

Rickets is a disease associated with failure of mineralization of growing bones in children.1,2 Rickets may be associated with growth retardation, muscle weakness, hypocalcaemia and alopecia totalis3. Rickets results from defective metabolism of calcium, phosphorus and/or vitamin D.4,5,6 Calcium and vitamin D are important nutrients for skeletal growth and bone health.7 Rickets can be caused by nutritional deficiencies or genetic disorders.4 Nutritional rickets is a health problem in developing countries.8 The most common cause of rickets is vitamin D deficiency.1 Genetic rickets; mostly resulted from mutations in the vitamin D receptor gene.3,9 Active vitamin D has an important role in calcium regulation and bone metabolism.10 Children are particularly vulnerable to 25-hydroxyvitamin D deficiency.7 Vitamin D regulates skeletal homeostasis both indirectly and directly.11 Nutritional type rickets is a child health problem in developing countries.5 Rickets is common among children with severe acute malnutrition and it is associated with increased risks of severe pneumonia and death.12 Vitamin D deficiency with or without calcium deficiency may lead to nutritional rickets.7 Vitamin D; can be synthesized in the skin or absorbed from the diet.11 Renal disorders also effect on mineralization and may be associated with rickets.1 Generally, clinical presentation of the rickets is heterogeneous and includes bone pain and deformities, muscle weakness, short stature and profound sweating.4,2 Rickets increases children susceptibility to infectious diseases.11 There is an association between rickets and some infectious diseases like hematogenous osteomyelitis in children.13 In the differential diagnosis of different forms of rickets; the detailed family history, physical examination, biochemical assessment and X-ray imaging are required.11,2 This study aimed to find the characteristics of rickets at JafarIbn Auf pediatric hospital in Sudan.