title: [Nutritional rickets in childhood: analysis of 62 cases].
abstract: OBJECTIVE
  Until recently, rickets secondary to vitamin D deficiency was considered a medical oddity rather than a clinical reality in Catalonia (Spain). However, recent data show a reemergence of the disease in the infancy.
  
  
  METHODS
  Retrospective clinical survey of epidemiologic and clinical features of infants and children (34 boys and 28 girls) diagnosed of nutritional rickets in pediatric departments of Catalonia (Spain) over the last 10 years.
  
  
  RESULTS
  Mean age (SD) at diagnosis was 9.9 (7) months (range: 3-36), 35.5% were under 6 months. Race distribution: blacks 61.3%, dark-skinned 36%; white 6.4%. Country of origin: Sub-Saharan Africa 59.7%, Morocco 33.9%, Catalonia 3.2%, Pakistan 1.6%. Seasonal distribution: 60% were diagnosed in autumn and winter. At diagnosis, 72% were following an exclusive milk diet (48% maternal milk alone) without vitamin D supplementation. Most common clinical presentation in infants under 6 months was: hypocalcemic tetany/seizures; in children aged 6-12 months: failure to thrive; and in children over 12 months: skeletal deformities. Weight and height expressed as z-score value at diagnosis was 0.67 and 0.91, respectively.
  
  
  CONCLUSIONS
  Nutritional rickets is a current reality in Catalonia and it mainly affects immigrant infants and children from Sub-Saharan Africa and Morocco, black or dark-skinned, fed with maternal milk alone, without vitamin D supplementation and with little sun exposure. Systematic, preventive supplementation with vitamin D is essential in these populations.
authors.affiliation: Unidad de Endocrinología Pediátrica. Servicio de Pediatría. Hospital Universitario Maternoinfantil Vall d'Hebron. Barcelona. España. dyeste@cs.vhebron.es
authors.forename: Diego
authors.initials: D
authors.lastname: Yeste
authors.forename: Antonio
authors.initials: A
authors.lastname: Carrascosa
mesh_terms: D017677:Age Distribution; D000886:Anthropometry; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009752:Nutritional Status; D012189:Retrospective Studies; D012279:Rickets / Q000453:epidemiology* / Q000628:therapy; D013030:Spain / Q000453:epidemiology; D018709:Statistics, Nonparametric