Radiological and biochemical resolution of nutritional rickets with calcium.
OBJECTIVE
To determine the response to oral calcium in Nigerian children with rickets.


METHODS
In a teaching hospital in Western Nigeria, 26 children (13 boys, 13 girls, aged 2-5 years) with confirmed rickets received calcium lactate (2.7 g/day).


RESULTS
Within one month of treatment leg pain was relieved and the children were more active. The mean x ray score improved from 3.3 at baseline to 1.7 at three months and 0.9 at six months (arbitrary scoring system, 0-6). Twelve cases were healed radiologically after six months, 11 others improved considerably, two showed no significant improvement, and a non-compliant patient was worse. There was progressive reversal of biochemical features. Median plasma alkaline phosphatase fell from 519 (range 178-1078) to 283 (209-443) IU/l (p = 0.04) in four months, while mean 1,25-dihydroxyvitamin D fell from 473 (251-1057) to 281 (155-481) pmol/l (p = 0.04), and mean plasma calcium increased from 2.26 (1.63-2.54) to 2.37 (2.06-2.54) mmol/l (p = 0.13). Parathyroid hormone fell from 5.3 (0.4-21.5) to 1.7 (0.45-7.4) pmol/l. Type I collagen carboxy terminal cross linked telopeptide was very high at baseline (20 (7.2-103) to 14 (11-24) micro g/l) (p = 0.03) and fell promptly to normal.


CONCLUSIONS
Calcium supplementation alone effected healing of rickets in most of these Nigerian children and may provide sufficient treatment in this environment.
Oginni
L M
LM
Department of Orthopaedic Surgery, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
Sharp
C A
CA
Badru
O S
OS
Risteli
J
J
Davie
M W J
MW
Worsfold
M
M
D002118:Calcium / Q000097:blood / Q000172:deficiency*; D002136:Calcium, Dietary / Q000008:administration & dosage*; D002675:Child, Preschool; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008297:Male; D009549:Nigeria; D011859:Radiography; D012279:Rickets / Q000097:blood / Q000000981:diagnostic imaging / Q000178:diet therapy*; D016896:Treatment Outcome
D002136:Calcium, Dietary; D002118:Calcium