METABOLISM OF VIT-D AND CALCIUM WITH RICKETS AND OSTEOMALACIA
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10 August 2017
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
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