rss
Arch Dis Child 2003;88:812-817 doi:10.1136/adc.88.9.812
  • Acute paediatrics

Radiological and biochemical resolution of nutritional rickets with calcium

  1. L M Oginni1,
  2. C A Sharp2,
  3. O S Badru1,
  4. J Risteli3,
  5. M W J Davie2,
  6. M Worsfold2
  1. 1Departments of Orthopaedic Surgery and Traumatology, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
  2. 2Charles Salt Research Centre, Robert Jones and Agnes Hunt Orthopaedic & District Hospital NHS Trust, Oswestry, Shropshire SY10 7AG, UK
  3. 3Department of Clinical Chemistry, University of Oulu, Oulu, Finland
  1. Correspondence to:
    Dr M Worsfold, Charles Salt Research Centre, Robert Jones and Agnes Hunt Orthopaedic & District Hospital NHS Trust, Oswestry, Shropshire SY10 7AG, UK;
    mike.worsfold{at}rjah.nhs.uk
  • Accepted 11 December 2002

Abstract

Aims: To determine the response to oral calcium in Nigerian children with rickets.

Methods: In a teaching hospital in Western Nigeria, 26 children (13 boys, 13 girls, aged 2–5 years) with confirmed rickets received calcium lactate (2.7 g/day).

Results: Within one month of treatment leg pain was relieved and the children were more active. The mean x ray score improved from 3.3 at baseline to 1.7 at three months and 0.9 at six months (arbitrary scoring system, 0–6). Twelve cases were healed radiologically after six months, 11 others improved considerably, two showed no significant improvement, and a non-compliant patient was worse. There was progressive reversal of biochemical features. Median plasma alkaline phosphatase fell from 519 (range 178–1078) to 283 (209–443) IU/l (p = 0.04) in four months, while mean 1,25-dihydroxyvitamin D fell from 473 (251–1057) to 281 (155–481) pmol/l (p = 0.04), and mean plasma calcium increased from 2.26 (1.63–2.54) to 2.37 (2.06–2.54) mmol/l (p = 0.13). Parathyroid hormone fell from 5.3 (0.4–21.5) to 1.7 (0.45–7.4) pmol/l. Type I collagen carboxy terminal cross linked telopeptide was very high at baseline (20 (7.2–103) to 14 (11–24) μg/l) (p = 0.03) and fell promptly to normal.

Conclusion: Calcium supplementation alone effected healing of rickets in most of these Nigerian children and may provide sufficient treatment in this environment.

Footnotes

  • O S Badru is deceased

This Article

  1. Abstract
  2. Full text
  3. PDF

Responses

  1. Submit a response
  2. No responses published

Register for free content


Free trial
Individuals may register for a free 30 day online trial to all content.

Free archive
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.