title: Two cases of rickets presenting with poor growth, hypotonia, and respiratory problems.
abstract: Rickets is a rare disease in developed countries. In children, it is a disease which affects growing bone. Depending on the severity, it can present with a wide variety of symptoms. Because it is such a rare disease in developed countries, symptoms suggesting rickets are often not easily recognized. This can cause a delay in diagnosing and treating rickets. Often unnecessary and sometimes invasive investigations are performed. First leading clues to rickets on physical examination are poor growth, especially length, thickening of wrists, bow legs, and craniotabes. At further examination, special attention should be paid to osteopenia and cupping and fraying at the metaphyses on X-rays. Laboratory results suggestive for rickets are elevated alkaline phosphatase and disturbances in calcium and phosphate homeostasis. In this report, we present two cases presenting with poor growth, severe pain, and respiratory problems secondary to calcipenic rickets.
authors.forename: E
authors.initials: E
authors.lastname: Wouters
authors.forename: M
authors.initials: M
authors.lastname: Wojciechowski
authors.forename: E
authors.initials: E
authors.lastname: de Vries
mesh_terms: D000469:Alkaline Phosphatase / Q000097:blood; D050071:Bone Density Conservation Agents / Q000008:administration & dosage; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging / Q000209:etiology; D002118:Calcium / Q000097:blood / Q000627:therapeutic use; D005183:Failure to Thrive / Q000209:etiology*; D006801:Humans; D006887:Hydroxycholecalciferols / Q000008:administration & dosage*; D007223:Infant; D008297:Male; D009123:Muscle Hypotonia / Q000209:etiology*; D010710:Phosphates / Q000097:blood / Q000627:therapeutic use; D011859:Radiography; D012131:Respiratory Insufficiency / Q000209:etiology*; D012279:Rickets / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome; D014807:Vitamin D / Q000097:blood / Q000627:therapeutic use
chemical_list: D050071:Bone Density Conservation Agents; D006887:Hydroxycholecalciferols; D010710:Phosphates; D014807:Vitamin D; D000469:Alkaline Phosphatase; D002118:Calcium; C008088:alfacalcidol
keywords: Failure to thrive,; Osteopenia,; Poor growth; Rickets,; Vitamin D,