Early clinical manifestations of rickets

Written by Li Jiao Yan
Neonatology
Updated on September 05, 2024
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Early Symptoms of Rickets:

Rickets is a chronic nutritional disease caused by a deficiency in Vitamin D, leading to disordered calcium and phosphorus metabolism and resulting in abnormal skeletal development. It primarily affects infants, especially those under six months old, with the highest occurrence in infants under three months. The general symptoms include heightened neural excitability, such as fussiness, easy irritability, sudden bouts of crying, or being so sensitive that they cry when touched. Other symptoms include excessive sweating and frequent head shaking, though these are not specific indicators of rickets.

Diagnosis mainly relies on biochemical markers and Vitamin D levels, like decreased blood calcium and phosphorus levels, elevated parathyroid hormone levels, and reduced 25-hydroxy-D3. X-ray images of bones might appear normal.

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Written by Mo Ming Hua
Pediatrics
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Does rickets affect development and intelligence?

Rickets is primarily caused by a deficiency in vitamin D and mainly affects normal growth and development, with very little to no impact on intelligence. In the early stages of rickets, symptoms mainly include irritability, restlessness, and excessive sweating at night. The body primarily exhibits symptoms such as sweating, night terrors, and irritability, with symptoms becoming significantly more pronounced. During this period, the main manifestations are skeletal deformities, which vary in different age groups. For example, there can be softening of the skull, as well as pectus excavatum, pectus carinatum, and X-shaped or O-shaped legs. In severe cases, spinal deformities may also occur.

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Written by Li Jiao Yan
Neonatology
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What foods are good for rickets?

Rickets is a global chronic nutritional disease caused by a deficiency of vitamin D, leading to disorders in calcium and phosphorus metabolism and abnormal bone development. The main issue stems from the lack of vitamin D, which causes abnormalities in the body's calcium levels, thus it's important to ensure dietary intake of vitamin D. For early infancy, it is generally recommended to strengthen feeding practices. Infants under six months should be exclusively breastfed until six months of age, followed by timely introduction of complementary foods. Cod liver oil, which is rich in vitamin D, should be routinely supplemented starting from the second week after birth, along with regular monitoring of growth and development. As complementary foods are introduced, try to include vitamin-rich vegetables and appropriately supplement with calcium-rich foods, such as certain seafood, while being mindful of potential allergies in children. Additionally, it is beneficial to include some high-protein, nutritious foods. Most importantly, children should persist in outdoor activities to get ample sunlight and continue supplementing with cod liver oil.

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Written by Li Jiao Yan
Neonatology
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Why does rickets cause sweating?

Rickets is a chronic, nutritional disease characterized by skeletal lesions due to a deficiency of vitamin D in the body, leading to disturbances in calcium and phosphorus metabolism. It is primarily caused by a lack of vitamin D, which can increase neural excitability. Research shows that the vitamin D metabolite, 1,25-dihydroxyvitamin D3, is not only an essential nutrient but also a precursor to hormones. It is potentially related to various cells including those in the thyroid, pancreas, stomach, brain, and those involved with calcium balance, as well as the immune, endocrine, reproductive systems, skin, and tumors. A deficiency in vitamin D can increase myocardial excitability and lead to symptoms like excessive sweating.

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Written by Li Jiao Yan
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Can rickets be cured?

Can rickets be cured? Rickets, also known as nutritional vitamin D deficiency rickets, is primarily caused by insufficient levels of vitamin D in the body leading to disorders in calcium and phosphorus metabolism. It is a chronic nutritional disease characterized by skeletal lesions. Typically, it manifests as flawed mineralization of long bones and bone tissue at the growth plates. Vitamin D deficiency rickets is a self-limiting disease that can generally be cured if children have sufficient outdoor activities and adequate exposure to sunlight. Adequate sunlight exposure and physiological doses of vitamin D can treat rickets. Therefore, it is usually recommended that children supplement with 400 units of vitamin D starting about two weeks after birth to prevent and treat rickets. However, if the child is in a later stage and shows obvious skeletal deformities, corrective treatment may be necessary. In severe cases of rickets where intracranial lesions occur, it might affect the child's vital signs and, in serious cases, could even lead to the child's death. Therefore, it is advised that children get plenty of sunlight, routinely supplement with vitamin D, and have regular pediatric check-ups to assess their condition.

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If rickets is not treated, what will be the impact?

Rickets, if untreated, mainly involves changes in skeletal deformities and motor function in children. Rickets is primarily caused by a deficiency in vitamin D, which is essential for promoting the absorption of calcium. A deficiency in vitamin D leads to reduced calcium absorption. Lower calcium absorption results in a calcium deficiency in the body, which in turn causes changes in the bones. In the early stages of vitamin D deficiency, the main symptoms are increased neural excitability, which may manifest as startle reactions, irritability, restlessness, and excessive sweating. During the active phase, symptoms of increased nervous system excitability become more pronounced, mainly presenting as skeletal deformities. What aspects do these skeletal deformities affect? One is the softening of the skull, pigeon chest, funnel chest, and changes resembling wristbands and anklets. If the condition worsens further, it can present as X-shaped legs, O-shaped legs, and spinal deformities. Thus, if rickets progresses, it can lead to skeletal deformities and impairments in motor functions, among other issues.