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Clinical Pediatrics
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Reviews

10-Year Case Review of Nutritional Rickets in Children's Hospital of Michigan

Judith P. Lazol, MD

Pittsburgh Children's Hospital, Pittsburgh, Pennsylvania

Nedim Çakan, MD

Children's Hospital of Michigan, Detroit, Michigan

Deepak Kamat, , MD, PhD

Children's Hospital of Michigan, Detroit, Michigan, dkamat{at}med.wayne.edu

Nutritional rickets has been on the rise in the United States. A chart review of patients with nutritional rickets from April 1995 to May 2005 was performed. Fifty-eight subjects were studied (62% males, 38% females, with an age range between 2 and 132 months). Of the subjects, 81% were African Americans and 14% were Arabic; 33% were Christians and 19% were Muslims. An increasing number of cases of nutritional rickets have been noted since 2000. Seventy-nine percent of patients with nutritional rickets presented at the emergency department, and in 69% of the cases, rickets was an incidental finding; 96% of patients were exclusively breast-fed, and none received multivitamin supplements. 25-OH vitamin D levels were below 5 ng/mL in 42% of the patients, all of whom were African Americans. We could document complete resolution of nutritional rickets in only 8 patients, and 3 of these patients showed sequelae of rickets.

Key Words: nutritional rickets • vitamin D • vitamin D 25(OH) • vitamin D 1,25 (OH) • breast-feeding • vitamin D supplementation

This version was published on May 1, 2008

Clinical Pediatrics, Vol. 47, No. 4, 379-384 (2008)
DOI: 10.1177/0009922807311397
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