A practical approach to rickets.
Rickets is a condition in which there is failure of normal mineralisation (osteomalacia) of growing bone. Whilst osteomalacia may be present in adults, rickets cannot occur. It is generally caused by a lack of mineral supply which can either be as a result of deficiency of calcium (calciopaenic rickets) or of phosphate (phosphopaenic rickets) although, in addition, renal tubular acidosis may also interfere with the process of mineralisation and cause rickets. Only calciopaenic and distal renal tubular disorders will be discussed in this chapter. The commonest cause of rickets is still vitamin D deficiency which is also responsible for problems other than rickets. Disorders of vitamin D metabolism or responsiveness may also cause similar problems. Distal renal tubular acidosis may be caused by a variety of metabolic errors similar to those of osteoclasts. One form of DRTA also causes a form of osteopetrosis. This chapter describes these conditions in detail and sets out a logical approach to treatment.
Allgrove
Jeremy
J
Department of Paediatric Endocrinology, Royal London Hospital, Whitechapel, London, UK. jeremy.allgrove@bartsandthelondon.nhs.uk
D015090:25-Hydroxyvitamin D3 1-alpha-Hydroxylase / Q000172:deficiency / Q000378:metabolism; D000141:Acidosis, Renal Tubular / Q000209:etiology / Q000378:metabolism; D002648:Child; D006801:Humans; D010018:Osteomalacia / Q000209:etiology; D010022:Osteopetrosis / Q000150:complications; D012279:Rickets / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D014807:Vitamin D / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000628:therapy; D014815:Vitamins / Q000627:therapeutic use
D014815:Vitamins; D014807:Vitamin D; D015090:25-Hydroxyvitamin D3 1-alpha-Hydroxylase