[Rickets secondary to celiac disease [a study of new case]]

ABSTRACT

Rickets secondary to celiac disease is rarely reported in children. We report a new paediatric observation. A 4-year-old girl presented for pallor associated with genu valgum evolving since the age of 3 years. She had experienced intermittent diarrhea since the age of 2 years. Physical examination revealed signs of rickets. Phosphocalcic assessment was disturbed with hypocalcaemia, hyperparathyroidism, low urinary calcium level and elevated level of serum total alkaline phosphatase. Radiography revealed metaphysical epiphysis abnormalities. The result of antibody screening for celiac disease [anti-gliadin, antiendyomysial and antitissue transglutaminase antibodies] was highly positive. Histological examination of duodenal biopsy showed an atrophy of the intestinal mucous membrane suggestive of celiac disease. Treatment with a gluten-free diety yielded remarkable improvement. Celiac disease should be considered in children with rickets, especially because intestinal symptoms may be mild