Vitamin D resistant rickets in children

Vitamin D resistant rickets is caused by a variety of heritable and acquired conditions. Thus Corm of rickets is a real diagnostic and therapeutic challenge. To find out the pattern of the different types of vitamin D resistant rickets, a study was conducted in the Department of Pediatrics. Postgraduate Medical Institute Lahore and Lahore General Hospital, Lahore for a period of one year from 1st August 1994 to 31st July 1995. A total of 30 children who fulfilled the criteria for vitamin D resistance were included in the study. All the patients were evaluated in detail. The patient's ages ranged from 0.25 to 12 years [Median age 2.7 years]. Most of the cases were seen between I-5 years wish male to female ratio of 1:1.14. About 70% of the patients fell in category of heritable conditions such as familial hypophosphatemia [26.66%], vitamin D dependent rickets type 1 [13.33%] and VDDR-II [6.66%], renal tubular acidosis [13.33%], Bartter syndrome [6.66%] and Fanconi syndrome [3.33%]. The acquired conditions seen were renal osteodystrophy [16.66%], rickets due to malabsorption [6.66%], rickets related to anticonvulsants [3.33%] and prematurity [3.33%]. In boys, the commonest cause was familial hypophosphatemia [35.71%] followed by renal osteodystrophy [17.64%]. In girls the commonest cause was vitamin D dependent rickets type I [25%] followed by familial hypophosphatemia [18.75%]. Most of the patients had marked stunting and skeletal deformities. The response to treatment was encouraging in many cases but was poor in renal osteodystrophy and vitamin D dependent rickets type II

Haemolytic-uraemic syndrome: therapy and prognostic features

Thirty five children with Haemolytic-Uraemic Syndrome [HUS] were seen between July 1989 to December, 1990 at the Department of Paediatrics, King Edward Medical College and Mayo Hospital, Lahore. All developed HUS following an episode of diarrhoea or respiratory infection. Mean age at presentation was 19 months and peak incidence of disease was in summer months. Twenty four of the thirty five children [69%] had a favourable outcome with complete recovery. Eight children [23%] died in the acute phase of the illness and three children developed chronic renal failure [8%]. This study indicates that younger age, shorter period of anuria, absent CNS manifestations and institution of early peritoneal dialysis are associated with a good outcome