title: Variable presentations of rickets in children in the emergency department.
abstract: Vitamin D-deficient rickets is uncommon but becoming more prevalent in the pediatric population likely related to increases in breast-feeding. It should be considered in many clinical situations. We present 3 cases of rickets presenting acutely to the emergency department. Their presentations included a fracture concerning for child abuse, tetany, and hypocalcemic seizures. In all cases, laboratory and radiographic evaluations were consistent with the diagnosis of nutritional rickets and their symptoms were related to rickets resolved with appropriate treatment. Although uncommon, vitamin D-deficient rickets should be considered in children with the above presentations.
authors.affiliation: Department of Pediatrics, University of Washington and Children's Hospital and Regional Medical Center, Seattle, WA.
authors.forename: Erete
authors.initials: E
authors.lastname: Bloom
authors.forename: Eileen J
authors.initials: EJ
authors.lastname: Klein
authors.forename: Denise
authors.initials: D
authors.lastname: Shushan
authors.forename: Kenneth W
authors.initials: KW
authors.lastname: Feldman
mesh_terms: D000469:Alkaline Phosphatase / Q000097:blood; D001942:Breast Feeding; D002118:Calcium / Q000097:blood / Q000627:therapeutic use; D004636:Emergency Service, Hospital; D005260:Female; D050723:Fractures, Bone / Q000209:etiology*; D006801:Humans; D006996:Hypocalcemia / Q000150:complications; D007223:Infant; D008297:Male; D010758:Phosphorus / Q000097:blood; D012279:Rickets / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D012640:Seizures / Q000209:etiology*; D013746:Tetany / Q000209:etiology*; D014807:Vitamin D / Q000627:therapeutic use
chemical_list: D014807:Vitamin D; D010758:Phosphorus; D000469:Alkaline Phosphatase; D002118:Calcium