Early manifestations of rickets

Written by Li Jiao Yan
Neonatology
Updated on September 06, 2024
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Rickets is a disease caused by a lack of vitamin D, which leads to a disorder in calcium and phosphorus metabolism, resulting in abnormal bone development. It primarily appears in the early stages in infants within six months old, and particularly within three months after birth. The initial presentation is an increase in nervous excitability, such as fussiness and unease in children, symptoms like excessive internal heat and sweating, especially more sweat on the head. Continuous sweating can lead to significant baldness at the back of the head. Sometimes, children may exhibit constant head shaking, but these are not very specific symptoms. Early detection involves decreased blood calcium and phosphorus levels, increased parathyroid hormone levels, and decreased levels of related markers in blood tests. Early bone X-rays appear normal, so initial symptoms are not so typical. Therefore, it is recommended that infants be taken to a pediatrician for a physical examination as soon as possible, where their developmental status can be assessed and rickets can be diagnosed. If it is early-stage vitamin D deficiency rickets, timely supplementation of vitamin D levels can be an effective cure.

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Written by Tong Peng
Pediatrics
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Can rickets with rib eversion in babies be cured?

Babies with rib flaring can be treated, but it requires assessment based on relevant clinical symptoms and laboratory tests. First, it is necessary to understand that rickets is a metabolic bone disease caused by a deficiency of vitamin D, which often results not only in rib flaring but also in square skull, pigeon chest, and either bowlegs or knock-knees. Neurologically, symptoms may include night sweats, easy startling during sleep, and poor sleep quality. When these conditions occur, a physical examination by a specialist is essential, along with comprehensive tests, including measuring the specific levels of vitamin D, and selecting appropriate vitamin D supplements. If the symptoms of rib flaring are severe and accompanied by a noticeable pigeon chest, orthotic supports may also be necessary for correction. If rib flaring affects normal breathing, severe cases may require surgical treatment. Therefore, the extent of severity based on clinical symptoms will dictate the treatment approach—whether it is oral medication, orthotic correction, or surgery.

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Written by Yao Li Qin
Pediatrics
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Can rickets be vaccinated against?

Children with rickets can be vaccinated, as rickets is not listed among the contraindications for vaccination. Rickets is a disease caused by a deficiency of vitamin D, a nutritional issue. Once diagnosed with rickets, it is essential to treat the child promptly by supplementing vitamin D. Generally, if treated early during infancy, rickets can be cured. To prevent rickets, all children should supplement with the physiological requirement of vitamin D from birth, engage in outdoor activities, and get ample sunlight to thoroughly prevent the occurrence of rickets. Rickets does not affect the administration of vaccines, nor does vaccination exacerbate the symptoms of rickets. Therefore, it is clear that children with rickets can be vaccinated.

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Written by Li Jiao Yan
Neonatology
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How to treat rickets in a 2-year-old baby?

Rickets in two-year-old infants is caused by a deficiency in vitamin D leading to a disturbance in calcium and phosphorus metabolism, resulting in abnormal skeletal development. This class of systemic, chronic, nutritional diseases typically manifests in two-year-olds who are able to walk and stand. Due to the force of gravity, lower limb deformities may develop, leading to bowlegs or knock-knees, and possibly even a 'K'-shaped limb deformity. The spine may also develop kyphosis or scoliosis. Around the age of two, it is generally the residual stage of the disease, which often does not require pharmacological treatment. For mild to moderate cases, physical exercise should be enhanced, and active or passive rehabilitation methods should be used to correct skeletal deformities. It is recommended to seek treatment in the pediatric rehabilitation department; severe skeletal deformities may require surgical correction.

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Written by Yao Li Qin
Pediatrics
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Causes of Rickets

Rickets, also known as Vitamin D-deficiency rickets, implies from its name that the cause of the disease is due to insufficient intake of Vitamin D in children, leading to disorders in calcium and phosphorus metabolism and resulting in nutritional disease with skeletal deformities. The incidence of the disease is higher in the north than in the south. Currently, the incidence of mild and moderate rickets is relatively high, while severe cases are less common because people are increasingly paying attention to the supplementation of Vitamin D for children. It is recommended that full-term infants start supplementing with 400 units of Vitamin D daily two weeks after birth, which is the physiological requirement. For premature infants, twins, and extremely low birth weight infants, the daily physiological requirement of supplementation is 800 units per day. After supplementing continuously for three months, it should be adjusted to 400 units per day as per the requirement for full-term infants. With such management, the child will not suffer from rickets. However, if there is no regular supplementation after birth, the lack of Vitamin D can lead to skeletal changes in the child, and once rickets is diagnosed, it requires high doses of supplementation.

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Written by Li Jiao Yan
Neonatology
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What is the treatment method for rickets?

Rickets is primarily caused by a deficiency in vitamin D, leading to disturbances in calcium and phosphorus metabolism in the body, which results in abnormal skeletal development—a type of systemic nutritional disease. The most common form is nutritional rickets due to a deficiency in nutrients and vitamin D. Treatment focuses on controlling the active phase to prevent relapse of deformities. Therefore, early detection and comprehensive treatment are crucial. The primary treatment method involves supplementing with vitamin D. The choice of vitamin D, the dosage, and the length of treatment generally need to be tailored to the specific circumstances of the child. Additionally, increased exposure to sunlight and appropriate outdoor activities should be encouraged to enhance the absorption of vitamin D. Children should also be supplemented with calcium and a variety of vitamins. Follow-ups during the recovery phase are necessary, and training in sitting, standing, and walking should not be started too early to avoid deformities in the lower limbs. Furthermore, no medication is needed during the residual stage of the disease. For mild to moderate cases, physical exercise should be intensified, and skeletal deformities can be corrected using active or passive exercises. Severe skeletal deformities may require surgical correction.