title: Fractures in biliary atresia misinterpreted as child abuse.
abstract: Bone fractures in children without a history of injury are highly suspicious for child abuse. Biliary atresia is a disorder associated with metabolic bone disease, and there are numerous reports of osteopenia, rickets, and/or fractures in this population. We report 3 cases of children with biliary atresia who had bony fractures as well as osteopenia whose caretakers were investigated for child abuse. Pediatricians should be aware of an increased incidence of fractures and overall prevalence of bone disease in this population.
authors.affiliation: Department of Pediatrics, Division of Pediatric Gastroenterology and Nutrition, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA. tderusso@jhmi.edu
authors.forename: Patricia A
authors.initials: PA
authors.lastname: DeRusso
authors.forename: Melissa R
authors.initials: MR
authors.lastname: Spevak
authors.forename: Kathleen B
authors.initials: KB
authors.lastname: Schwarz
mesh_terms: D001656:Biliary Atresia / Q000150:complications* / Q000601:surgery; D001851:Bone Diseases, Metabolic / Q000209:etiology; D002649:Child Abuse / Q000175:diagnosis*; D003951:Diagnostic Errors; D005260:Female; D005598:Fractures, Spontaneous / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D006996:Hypocalcemia / Q000209:etiology; D007223:Infant; D008286:Malabsorption Syndromes / Q000209:etiology; D019221:Mandatory Reporting; D011171:Portoenterostomy, Hepatic; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy; D014807:Vitamin D / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000188:drug therapy / Q000209:etiology
chemical_list: D014807:Vitamin D