A study of Rickets - Morbidity and Aetiology of a Low profile Disorder

Abstract

in a prospective study undertaken at the paeds 'A' unit HSTH, Peshawar, a total of one hundred and sixty eight (168) cases of Rickets were registered over one year period. After clinical evaluation and investigations one hundred and twenty four cases (73.8%) out of the total were attirbuted to Vit D deficiency. The remaining forty four cases, (26.2%) of Rickets in decreasing order of frequency were due to renal tubular disorders of phosphate absorption (Familial Rickets), malabsorptive  states, chornic renal disease, hepatobiliary disorders, use of anticonvulsant drugs and assocaited with rare -disorders like renal tubular acidosis, de Toni-Fanconi, Di George syndrome. In the vitamin D deficinency group, the male infants and children (62%) predominated the female children (38%) whose mean age of presentation (23 months) was later than the male group (14 months). . The commonest clinical presentation was in the form of recurrent lower respiratory infection (LRT) (48%). In this group 60% patient had wheeze in addition to LRTI. other patterns of clinical presentation were delayed motor development (28%), due to generalized hypotonia, diarrhoea and abdominal distention 22%, non febrile seizures 10%, breath holding attacks, and tetany in less than 10%. Seventy percent of the patients had one or more skeletal changes suggestive of Rickets on inital presentationbut not noticed by the parent.