LEADING ARTICLE

Rickets

Is nutritional rickets returning?

J Allgrove

Correspondence to:
Correspondence to:
Dr J Allgrove
Newham General Hospital, Glen Road, Plaistow, London E13 8RU, UK; jeremy.allgrove@newhamhealth.nhs.uk

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See original article by Ladhani et al (pp 781–4)

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Keywords: hypocalcaemia; rickets; vitamin D deficiency

The first 150 words of the full text of this article appear below.

Mineralisation of osteoid tissue of bone is dependent on a suitable supply of mineral, both calcium and phosphate, to that tissue. Failure to provide sufficient mineral results in osteomalacia which, in growing bone with its attendant growth plates and unfused epiphyses, is manifest as rickets. Although vitamin D deficiency is not the only cause of rickets (nutritional calcium deficiency has also recently been proposed as an important factor¹), it has historically been a major cause of morbidity.²

Vitamin D is mainly derived from the action of sunlight on 7-dehydrocholesterol in the skin, and vitamin D deficiency is more likely to occur in individuals with darker skins or in those whose skin is extensively covered.³ Vitamin D is converted via two enzymatic reactions to the active metabolite, 1,25-dihydroxyvitamin D (1,25-(OH)₂D), whose principal actions are to stimulate absorption of calcium by the gut and promote mineralisation of bone. Failure . . . [Full text of this article]

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Relevant Article

Presentation of vitamin D deficiency

S Ladhani, L Srinivasan, C Buchanan, and J Allgrove
Arch. Dis. Child. 2004 89: 781-784. [Abstract] [Full Text] [PDF]

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eLetters:

Read all eLetters

Return of rickets points to the broader public health issue - widespread vitamin D insufficiency

Daniel E Roth, et al.

ADC Online, 23 Aug 2004 [Full text]

Nutritional Ricketts is increasingly diagnosed in children of ethnic origin

Dr Egware Odeka FRCP FRCPCH, et al.

ADC Online, 31 May 2005 [Full text]