Vitamin D resistant rickets in children

ABSTRACT

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 11.14. 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