ABSTRACT
Congenital rickets is the term given to fetus born with clinical features of rickets, but those born with biochemical evidence of rickets without obvious clinical features still can be considered occult congenital rickets. Some of the affected babies with this disease have the intrauterine rachitic environment, but a calcium trans-placental pump prevents the fetus from having clinical features of rickets. They may present with hypocalcemia few days after birth or later with more florid features of rickets. Congenital rickets cases born with florid features reported over the last 40 years are few and can be divided into two groups. The first due to severe maternal osteomalacia in which their bones were so decalcified to have enough calcium to be pumped to their fetus. Another group in which newborn babies were hypocalcemic due to other maternal diseases as malabsorption, celiac disease, pre-eclampsia, and prematurity. All inherited rickets cases per se, or as part of other syndromes can be considered congenital rickets. Most cases seen in our region are due to maternal vitamin D deficiency with symptoms becoming obvious when the infants are breastfed, or may present with hypocalcemic convulsions or craniotabes. This is a review of congenital rickets with the aim of shedding light on this potentially acute disease that needs more attention and awareness in the neonatal period to avoid rare serious complications as cardiomyopathy or myelofibrosis and the complications of hypocalcemic convulsions. Congenital rickets cases seen simulate a tip of an ice-burg and its prevention is an important issue, especially with the tremendous urbanization with tall buildings living in sun-deprived flats as the commonest type of residence leading to the increasing incidence of maternal osteomalacia and rickets.
Subject(s)
Breast Feeding , Osteomalacia/etiology , Rickets/congenital , Rickets/epidemiology , Vitamin D Deficiency/complications , Animals , Celiac Disease/congenital , Celiac Disease/etiology , Humans , Hypocalcemia/pathology , Osteomalacia/pathologyABSTRACT
La deficiencia de vitamina D y el raquitismo son problemas de salud importantes en los países en desarrollo. El raquitismo congénito es una forma infrecuente de raquitismo. La deficiencia materna de vitamina D es el factor de riesgo más importante para la deficiencia de vitamina D y el raquitismo en los recién nacidos y lactantes. Presentamos el caso de un niño de 2 meses de edad, con convulsiones durante su hospitalización por neumonía. Se diagnosticó raquitismo congénito asociado a deficiencia materna de vitamina D.
Vitamin D deficiency and rickets are major health problems in developing countries. Congenital rickets is a rare form of rickets. Maternal vitamin D deficiency is the most important risk factor for vitamin D deficiency and rickets in newborns and early infancy. In this report, we presented a two-monthold infant with seizures while hospitalized for pulmonary infection. Finally, congenital rickets due to maternal vitamin D deficiency was diagnosed.
Subject(s)
Humans , Infant , Male , Hypocalcemia/etiology , Rickets/complications , Rickets/congenital , Seizures/etiology , Developing Countries , Vitamin D DeficiencyABSTRACT
La deficiencia de vitamina D y el raquitismo son problemas de salud importantes en los países en desarrollo. El raquitismo congénito es una forma infrecuente de raquitismo. La deficiencia materna de vitamina D es el factor de riesgo más importante para la deficiencia de vitamina D y el raquitismo en los recién nacidos y lactantes. Presentamos el caso de un niño de 2 meses de edad, con convulsiones durante su hospitalización por neumonía. Se diagnosticó raquitismo congénito asociado a deficiencia materna de vitamina D.(AU)
Vitamin D deficiency and rickets are major health problems in developing countries. Congenital rickets is a rare form of rickets. Maternal vitamin D deficiency is the most important risk factor for vitamin D deficiency and rickets in newborns and early infancy. In this report, we presented a two-monthold infant with seizures while hospitalized for pulmonary infection. Finally, congenital rickets due to maternal vitamin D deficiency was diagnosed.(AU)
Subject(s)
Humans , Infant , Male , Hypocalcemia/etiology , Rickets/congenital , Rickets/complications , Seizures/etiology , Developing Countries , Vitamin D DeficiencyABSTRACT
The cases of four newborn infants with congenital rickets are reported. All infants were native Canadian: three were Cree and one was Inuit. One had a narrow chest and pulmonary hypoplasia, two had clinical and radiological signs of rickets with craniotabes, thickened wrists, and prominent costochondral junctions, and one had perinatal asphyxia and hydrops. All had hypocalcemia, hypophosphatemia and secondary hyperparathyroidism. Serum 25-hydroxyvitamin D levels were low in three of the infants. The four mothers had evidence of vitamin D deficiency. All infants recovered following treatment with 5000 IU oral vitamin D daily.
