Etiology, Clinical Manifestations, Diagnosis, and Management of Vitamin D Deficiency, Rickets, and Hypervitaminosis D

Introduction

Vitamin D plays a crucial role in bone health and overall metabolic functions. Deficiencies in vitamin D can lead to serious skeletal disorders such as rickets in children, characterized by impaired bone mineralization.

Etiology of Rickets

Rickets is primarily caused by prolonged vitamin D deficiency, which can stem from inadequate dietary intake, lack of sun exposure, or malabsorption disorders.

• Dietary deficiency: Low intake of vitamin D-rich foods
• Reduced sunlight exposure: Insufficient UVB radiation for cutaneous synthesis
• Gastrointestinal disorders: Impaired absorption in conditions like celiac disease

Clinical Features and Symptoms of Rickets in Children

Children suffering from rickets exhibit characteristic signs and symptoms due to defective mineralization of bones.

• Bone pain and tenderness
• Delayed growth and development
• Deformities such as bowed legs or knock knees
• Hypocalcemic symptoms including muscle weakness and seizures

Diagnosis and Management

Diagnostic Approach

Diagnosis of rickets involves clinical evaluation, biochemical tests, and radiological findings.

• Serum 25-hydroxyvitamin D levels
• Elevated alkaline phosphatase
• Characteristic radiographic findings such as widened growth plates

Management Strategies

Management focuses on vitamin D supplementation and dietary modification.

• Vitamin D therapy (cholecalciferol or ergocalciferol)
• Increased dietary intake of vitamin D-rich foods
• Ensuring adequate sun exposure

Conclusion

Vitamin D deficiency is a preventable condition that can lead to rickets if left untreated. Early diagnosis and intervention ensure normal bone health and growth in children.