X-linked hypophosphatemic rickets and sagittal craniosynostosis: three patients requiring operative cranial expansion: case series and literature review.
OBJECTIVE
A defect in a phosphate-regulating gene leads to the most common form of rickets: X-linked hypophosphatemic rickets (XLH) or vitamin D-resistant rickets (VDDR). XLH has been associated with craniosynostosis, the sagittal suture being the most commonly involved.


METHODS
We present three patients with rickets and symptomatic sagittal suture craniosynostosis all of whom presented late (>2 years of age). Two had a severe phenotype and papilledema, while the third presented with an osseous bulging near the anterior fontanel and experienced chronic headaches.


RESULTS
All underwent successful cranial vault expansion.


CONCLUSIONS
Rachitic patients with scaphocephaly should be screened for craniosynostosis.
Department of Neurosurgery, Division of Pediatric Neurosurgery, University Childrens Hospital Basel, Basel, Switzerland.
Phillip
P
Jaszczuk
Division of Plastic and Reconstructive Surgery, Children's National Medical Center, Washington, DC, USA.
Gary F
GF
Rogers
Department of Neurosurgery, Division of Pediatric Neurosurgery, University Childrens Hospital Basel, Basel, Switzerland. raphael.guzman@usb.ch.
Raphael
R
Guzman
Department of Neurosurgery, Children's Hospital Boston, Boston, MA, USA.
Mark R
MR
Proctor
D002675:Child, Preschool; D003398:Craniosynostoses / Q000150:complications / Q000601:surgery*; D053098:Familial Hypophosphatemic Rickets / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods*; D012886:Skull / Q000601:surgery*; D016896:Treatment Outcome
Craniosynostosis; Dolichocephaly; Papilledema; Rickets; Scaphocephaly; Vitamin D-resistant rickets; X-linked hypophosphatemia