Early clinical manifestations of rickets

Written by Li Jiao Yan
Neonatology
Updated on September 05, 2024
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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 Huang Kun Mei
Pediatrics
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Symptoms of rickets in infants and young children

The symptoms of rickets in infants and young children mainly include excessive sweating, night terrors, thinning hair at the back of the head, rib cage flaring, pigeon chest, bow legs, and knock knees, among others. If a child exhibits the above symptoms, it is necessary to promptly test for trace elements and check bone density to see if the child has symptoms of calcium deficiency. If so, it is crucial to supplement the child with vitamin D and calcium. In terms of diet, it is necessary to enhance the child's nutrition and increase outdoor activities. Ensure that the child engages in outdoor activities for more than two hours each day, particularly between 12 PM and 2 PM. Avoid exposing the child to sunlight during this time to prevent sunburn, especially to the child's eyes.

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Written by Zeng Hai Jiang
Pediatrics
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The difference between rickets and rib flare

Rickets and rib flaring are different; rib flaring can be considered a symptom of rickets. Rickets is caused by a deficiency of vitamin D in infants and children, leading to abnormal metabolism of calcium and phosphorus, which results in incomplete calcification and softening of the bones, thereby causing skeletal deformities. Rickets can be divided into initial, active, recovery, and sequelae stages. During the active stage of rickets, skeletal deformities such as softened skull, "ping pong" head, square skull, rib flaring, pigeon chest, funnel chest, X-shaped legs, and O-shaped legs are prone to occur.

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Written by Li Jiao Yan
Neonatology
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Can rickets be cured?

Rickets is a type of disease caused by a lack of vitamin D, leading to disturbances in calcium and phosphorus metabolism in the body, and resulting in abnormal bone development. The most common form of this disease is nutritional rickets caused by a deficiency of vitamin D. This type of rickets is curable as it is a self-limiting disease. Generally, timely supplementation of vitamin D and calcium, along with sufficient outdoor activities, can lead to recovery after treatment. However, there are some special cases, such as severe liver and kidney diseases, which require addressing the root cause before the symptoms of vitamin D deficiency can be alleviated. Additionally, there are some genetic diseases for which vitamin D supplementation is ineffective, making their treatment more challenging.

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Written by Tong Peng
Pediatrics
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Will rickets lead to hunchback when grown up?

Rickets generally does not result in hunchback when one grows up, as rickets is a disease caused by a vitamin D deficiency leading to disturbances in calcium and phosphorus metabolism. If not cured before development is completed, it often leaves sequelae such as square skull, Harrison's groove, beaded ribs, as well as bow legs, knock knees, and pigeon chest. However, hunchback is mainly caused by developmental deformities of the thoracic and lumbar spine, and is not greatly related to a lack of vitamin D. However, it is also important to note that a deficiency in vitamin D can lead to osteoporosis, and if one does not maintain proper posture in daily life, such as bending the back while sitting, standing, or walking and not being able to stand straight, it may eventually lead to pathological curvature of the spine and thoracic vertebrae. Therefore, in daily life, it is still important to be conscious of using one’s lumbar and thoracic spine correctly to avoid developing a hunchback over time.

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Written by Li Jiao Yan
Neonatology
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Can rickets be inherited by the next generation?

Rickets, called vitamin D-deficiency rickets, is caused by a lack of vitamin D which leads to abnormal calcium and phosphorus metabolism in the body. This prevents calcium salts from properly depositing in the growing parts of the skeleton, resulting in incomplete mineralization of bone tissue during growth. It produces a systemic, chronic nutritional disease characterized by skeletal lesions and closely related to lifestyle. The primary causes of rickets are due to a combination of factors leading to vitamin D deficiency. Feeding methods, cod liver oil supplementation, living environment, time spent outdoors, recurrent respiratory infections, maternal calcium deficiency during pregnancy, and the season of birth are all significant contributing factors to the incidence of rickets. Generally, most cases of rickets are not inherited to the next generation. However, if there is a clear hereditary disease causing insufficient levels of vitamin D, it could potentially be inherited by the next generation.