Dr.M.ARAVINDH., MBBS

INTRODUCTION

1. Vit –D is a fat soluable vitamin that helps in normal bone growth in a child and that gets absorbed in intestine and also produced by skin when exposed to sunlight(UV rays).

2. Plays a major role in calcium ,phosphate regulation in our body.

VIT – D RICH ITEMS :

• MILK ,BREAST MILK
• DAIRY PRODUCTS – BUTTER,CHEESE
• FORTIFIED CEREALS
• FISH OIL
• EGG YOLK
• GREEN LEAF VEGETABLES

RICKETS :

• Inadequate or defective mineralization of growing bone before epiphyseal growth in children.
• More common in < 4 yrs of age.
• Incidence 24.1 per 100,000 in 2000 overall.
• Incidence 38 per 100,000 since yr 2000 in india.

TYPES OF RICKETS :

CLINICAL FEATURES:

lethargy

• Joint Pain
• Muscle Ache and Weakness
• Decreased Activity of the Child
• Tiredness
• Loss of Hair or thin Hair
• Thickening of wrist
• Seizures
• Short Stature

NUTRITIONAL RICKETS :

• Lack of dietary intake .
• Defective production vit –d in skin due to decreased exposure to sun light.
• Common rickets in India

SECONDARY RICKETSSECONDARY RICKETS :

• RENAL TUBULAR ACIDOSIS
• CHRONIC KIDNEY DISEASE
• ONCOGENIC RICKETS
• METAPHYSEAL DYSPLASIA
• FLUOROSIS

OSTEOMALACIA :

• Inadequate or defective mineralization of bone after epiphyseal closure in adults.
• Leads to fragile or soft bone formation.
• Due to vit –d deficiency.

CAUSES:

1.Short bowel syndrome(intestine bypass surgery)

• Hypophosphatemia,hypoparathyroidism,RF
• Drugs like barbiturates,phenytoin,rifampicin
• VITAMIN D deficiency and malabsorption

Impaired mineralization of bone matrix proteins

• Bowing of weight bearing bones(DEFORMITIES)
• (KNOCK KNEES)
• Skeletal fractures

Prevention :

• Vitamin d rich diet like

milk , egg , green leaf vegetables

• Plenty of sleep
• Regular exercise
• Sunlight exposure

COMPLICATIONS :

• SECONDARY HYPERPARATHYROIDISM
• REPIRATORY DISTRESS
• Tetany , psuedofractures
• CARDIOVASCULAR ABNORMALITIES
• SKELETAL DEFORMITIES
• SIEZURES
• Proximal MYOPATHY
• DEATH