All issues > Volume 53(2); 2010

Original Article

Korean J Pediatr. 2010;53(2):152-157. Published online February 15, 2010.

Clinical characteristics of vitamin D deficiency rickets in infants and preschool children

Kyoung K Huh¹, Mi Kyeong MK Woo¹, Jung Rim JR Yoon¹, Gyu Hong GH Shin¹, Myoung Jae MJ Chey¹, Mi Jung MJ Park¹

¹Department of Pediatrics, Inje University College of Medicine, Seoul, South Korea

Correspondence Mi Jung MJ Park ,Tel: +82.2-950-1075, Fax: +82.2-951-1246, Email: PMJ@paik.ac.kr

Abstract

Purpose
: Vitamin D deficiency rickets is a significant public health problem that results from insufficient exposure to sunlight and inadequate vitamin D supplementation. The purpose of this study is to identify the clinical characteristics of vitamin D deficiency rickets in infants.
Methods
: Data of 35 infants diagnosed as vitamin D deficiency rickets at Sanggye-Paik Hospital, Seoul, Korea, from March 2007 to May 2009 were reviewed. Children with plasma 25-hydroxyvitamin D levels<15 ng/mL and 15-30 ng/mL were considered to have vitamin D deficiency and vitamin D insufficiency, respectively.
Results
: Thirty-five infants (22 boys, 13 girls) were diagnosed with rickets. Mean age at diagnosis was 7.4¡¾7.1 months (range: 0.1-29.8 months). Eighteen infants (51%) were vitamin D deficient and seventeen infants (49%) were insufficient. Twenty-eight of all (80%) diagnosed as subclinical rickets. Twenty-nine infants (83%) were below the age of 12months. Twenty infants (57%) had breastfed and ten infants (29%) had iron deficiency anemia. Nine of breastfed infants (45%) were vitamin D deficient and ten of their mothers were vitamin D insufficient. Overall, radiographic evidence of rickets was present in 93% of the cases. Radiographic sign of rickets was evident even in vitamin D insufficient state.
Conclusion
: It is important for the clinician to screen for subclinical vitamin D deficiency rickets in inadequately supplemented infants by pairing 25-hydroxyvitamin D levels with wrist radiographs. A nationwide epidemiological study of vitamin D deficiency rickets must be conducted and evidence-based national guidelines must be defined to prevent rickets.

Keywords :Vitamin D deficiency, Rickets, Infant