]]>
Rickets (in children) and osteomalacia (in adults) are two forms of a metabolic bone disease resulting from
vitamin D]]>
deficiency. Both cause softening and weakening of bones because of defective or inadequate bone mineralization.
]]>
Rickets and osteomalacia result when there is a vitamin D deficiency in the body. This may occur when:
- The supply of vitamin D from the diet or sun exposure is inadequate.
- The metabolism of vitamin D is abnormal.
- Tissue is resistant to the action of vitamin D.
Vitamin D]]>
regulates
]]>calcium]]>
absorption in the body. It also controls levels of calcium and phosphate in bone. Vitamin D is absorbed in the intestines from food. Vitamin D is also produced by the skin during exposure to sunlight.
Most often, rickets and osteomalacia are caused by a deficiency of vitamin D. This can result from:
-
Insufficient vitamin D in the diet. In children, this may be related to:
- Insufficient consumption of vitamin D-fortified milk
-
Insufficient intake of vitamin D supplements to children being breastfed or to children who are
]]>lactose intolerant]]>
- Lack of exposure to sunlight.
Less often, rickets and osteomalacia can be caused by other disorders that affect vitamin D absorption, metabolism, or action in the body such as:
-
Kidney problems:
- A hereditary disorder of the kidney called vitamin D-resistant rickets
- Renal tubular acidosis—a nonhereditary kidney disorder which causes bone calcium to dissolve
-
Chronic
]]>kidney failure]]>
-
Long-term kidney
]]>dialysis]]>
- Diseases of the small intestines with malabsorption
- Disorders of the liver or pancreas disease
- Cancer
-
Certain drugs, such as:
- Certain seizure medications, such as
phenytoin
or
phenobarbital
- Acetazolamide
- Ammonium chloride
- Disodium etidronate
- Fluoride treatment
-
Toxicity or poisoning from:
- Cadmium
- Lead
- Aluminum
- Outdated tetracycline
]]>
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors for rickets/osteomalacia include:
-
Age in children: 6 to 24 months old
- Either the child is consuming breast milk (from a mother who is deficient in vitamin D) or milk not fortified with vitamin D.
- Age in adults: 50-80 years
- Lactose intolerance with inadequate intake of vitamin D-fortified milk
- Family history of rickets
- Race: Black, especially in association with breastfeeding
Symptoms may include:
- Bone pain and tenderness
- Skeletal and/or skull deformities
- Bow legs or knock knees
- Deformity or curvature of the spine
- Pigeon chest (forward protrusion of the chest bone)
- Impaired growth, resulting in short stature
- Susceptibility to bone fractures
- Dental deformities
- Delayed tooth formation
- Defects in teeth
- Increased cavities
- Loss of appetite or weight loss
- Difficulty sleeping
- Poor muscle development and tone
- Muscle weakness
- Delay of learning to walk in children
The doctor will ask about your symptoms and medical history, and perform a physical exam. Tests to confirm the diagnosis may include:
- Blood and urine tests
-
Bone
x-rays]]>
-
Bone
]]>biopsy]]>
, when other tests are not conclusive
Treatment attempts to:
- Correct the underlying cause
- Relieve or reverse symptoms
Treatment of the underlying cause may include:
-
Adding the following to your diet:
- Vitamin D-fortified dairy products
- Foods high in vitamin D (such as fatty fish, egg yolk, and green vegetables)
- Supplements of vitamin D, calcium, and other minerals
- Biologically active vitamin D
- Adequate but not excessive exposure to sunlight
Treatment to relieve or correct symptoms may include:
- Wearing braces to reduce or prevent bony deformities
- In severe cases, surgery to correct bony deformities
To help prevent rickets or osteomalacia:
- Drink vitamin D-fortified milk.
- Consume sufficient vitamin D, calcium, and other minerals. If you think your diet may be deficient, talk with your doctor about alternate sources of vitamins and minerals.
- Get sufficient, but not excessive, exposure to sunlight. Fifteen minutes a day is usually considered sufficient. Any longer than that requires sun protection with clothing or sunscreens, especially in fair-skinned infants or children. Children with dark skin and their mothers are at increased risk for rickets and may need more sun exposure and dietary supplementation with vitamin D.
- Breastfed, dark-skinned babies should receive 400 International Units per day (IU/d) of supplementation with vitamin D starting at no later than two months of age.
Last reviewed November 2008 by ]]>David L. Horn, MD, FACP]]>
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a
medical condition.
Copyright © 2007
EBSCO Publishing All rights reserved.