Which department should I go to for rickets?

Written by Li Jiao Yan
Neonatology
Updated on September 20, 2024
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Rickets, known as nutritional vitamin D deficiency rickets, is a chronic nutritional disease characterized by skeletal lesions, caused by a deficiency of vitamin D in the body leading to disturbed calcium and phosphate metabolism. In the early stages of rickets, it is primarily due to insufficient levels of vitamin D, which then leads to abnormal calcium and phosphate metabolism; at this stage, it is necessary to consult the endocrinology department to correct it timely. If rickets has already caused developmental deformities of the bones, orthopedic consultation is required for corrective treatment. For instance, if children exhibit pigeon chest, or noticeable bow legs or knock knees, they need to see an orthopedic specialist.

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Written by Li Jiao Yan
Neonatology
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Early clinical manifestations of rickets

Early Symptoms of Rickets: Rickets is a chronic nutritional disease caused by a deficiency in Vitamin D, leading to disordered calcium and phosphorus metabolism and resulting in abnormal skeletal development. It primarily affects infants, especially those under six months old, with the highest occurrence in infants under three months. The general symptoms include heightened neural excitability, such as fussiness, easy irritability, sudden bouts of crying, or being so sensitive that they cry when touched. Other symptoms include excessive sweating and frequent head shaking, though these are not specific indicators of rickets. Diagnosis mainly relies on biochemical markers and Vitamin D levels, like decreased blood calcium and phosphorus levels, elevated parathyroid hormone levels, and reduced 25-hydroxy-D3. X-ray images of bones might appear normal.

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Written by Yao Li Qin
Pediatrics
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Causes of Rickets

Rickets, also known as Vitamin D-deficiency rickets, implies from its name that the cause of the disease is due to insufficient intake of Vitamin D in children, leading to disorders in calcium and phosphorus metabolism and resulting in nutritional disease with skeletal deformities. The incidence of the disease is higher in the north than in the south. Currently, the incidence of mild and moderate rickets is relatively high, while severe cases are less common because people are increasingly paying attention to the supplementation of Vitamin D for children. It is recommended that full-term infants start supplementing with 400 units of Vitamin D daily two weeks after birth, which is the physiological requirement. For premature infants, twins, and extremely low birth weight infants, the daily physiological requirement of supplementation is 800 units per day. After supplementing continuously for three months, it should be adjusted to 400 units per day as per the requirement for full-term infants. With such management, the child will not suffer from rickets. However, if there is no regular supplementation after birth, the lack of Vitamin D can lead to skeletal changes in the child, and once rickets is diagnosed, it requires high doses of supplementation.

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Written by Li Jiao Yan
Neonatology
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Can rickets be treated?

Rickets is a disorder caused by a deficiency of vitamin D, leading to impaired calcium and phosphorus absorption, which then results in abnormal skeletal development. It is a chronic nutritional disease. Generally, the rickets commonly mentioned is due to nutritional vitamin D deficiency, which is treatable. Typically, encouraging children to engage in appropriate physical activities while supplementing with an adequate level of vitamin D can effectively control the disease, and it can even be cured. However, if there are special circumstances, such as significant liver abnormalities, renal function abnormalities, renal failure, or abnormalities in the thyroid or parathyroid glands, including parathyroid tumors, or congenital hereditary diseases, the treatment needs to be based on the cause in order to effectively control the disease and promote normal calcium and phosphorus metabolism in the body. Congenital hereditary diseases generally make treatment more challenging. Therefore, it is crucial for children with rickets to seek timely medical examination at a hospital. If it is a common case of nutritional vitamin D deficiency, parents should supplement vitamin D promptly according to the doctor's advice for treatment.

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Written by Yao Li Qin
Pediatrics
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Clinical manifestations of rickets

Rickets, also known as vitamin D deficiency rickets, occurs because children do not supplement vitamin D in a timely manner after birth, leading to a deficiency of vitamin D in the body and resulting in a nutritional metabolic disease primarily involving skeletal changes. In the early stages, children mainly show symptoms related to mental and emotional state, such as irritability, crying, excessive sweating, shaking their heads back and forth, and rubbing their heads. Subsequently, symptoms like bald patches on the back of the head and softening of the skull bones may appear. As children grow, they may develop conditions such as a square-shaped skull, beaded ribs, pigeon chest, funnel chest, and bracelet-like deformities around the wrists and ankles. In severe cases, children may later develop X-shaped legs and O-shaped legs. If rickets is suspected, it is crucial to promptly conduct a blood test to measure the vitamin D level. If the level is below normal, it is essential to actively treat the diagnosed rickets.

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Written by Li Jiao Yan
Neonatology
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How should children with rickets supplement calcium?

Rickets is a nutritional disease caused by a deficiency in vitamin D, leading to disturbances in calcium and phosphorus metabolism in the body, which results in abnormal bone development. It is mainly due to a lack of vitamin D, so the primary treatment is supplementing with vitamin D. Dairy is a reliable source of calcium nutrition for infants, and generally, it is not necessary to supplement calcium for the treatment of rickets; attention should be paid to supplementing with vitamin D according to the severity of the condition, and spending more time in the sun. For children who have started eating complementary foods, or older children, it is generally recommended to fully supplement vitamin D levels, spend more time in the sun during summer, and consume high-protein nutrients. Additionally, eating more vegetables and appropriately supplementing with calcium supplements in the winter is advised. The dosage should be based on the child's internal levels of calcium and phosphorus, with calcium supplementation adjusted accordingly.