Rickets is a disease that affects bone development in children due to vitamin D deficiency, calcium, or phosphate. It is treatable with proper nutrition and supplementation.

Written by Li Jiao Yan
Neonatology
Updated on December 26, 2024
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Rickets, also known as vitamin D deficiency rickets, is caused by a lack of vitamin D, leading to abnormal calcium and phosphorus metabolism in the body. The calcium salts cannot be properly deposited in the growing parts of the skeleton, causing incomplete mineralization of the bone tissue during growth. This results in a chronic systemic nutritional disease closely related to lifestyle, characterized by skeletal abnormalities. The most common is nutritional vitamin D deficiency, which is self-limiting. Typically, sufficient vitamin D supplementation and appropriate sun exposure can cure it. If caused by other severe diseases, vitamin D deficiency will significantly manifest liver and kidney function abnormalities. Additionally, some congenital genetic diseases make treatment more difficult when vitamin D levels are deficient.

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Written by Mo Ming Hua
Pediatrics
1min 15sec home-news-image

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.

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Written by Tong Peng
Pediatrics
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What are the early symptoms of rickets?

The early symptoms of rickets are mainly due to the inadequate intake of vitamin D in children, leading to disturbances in the body's calcium and phosphorus metabolism. Early signs usually appear around three months of age in infants, characterized by changes in mental state, restless sleep, frequent crying, and excessive sweating. Increased sweating is often accompanied by cradle cap, where circular bald patches appear on the back of the head. In such cases, it is important to include vitamin D-rich foods in the diet and supplement with vitamin D. Continued breastfeeding, engaging in outdoor activities, and exposure to sunlight are recommended to promote the body’s own synthesis of vitamin D. Regular physical examinations are also advised, and if symptoms of rickets occur, an appropriate increase in vitamin D intake may be necessary.

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Written by Li Jiao Yan
Neonatology
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Can rickets be inherited by the next generation?

Rickets, called vitamin D-deficiency rickets, is caused by a lack of vitamin D which leads to abnormal calcium and phosphorus metabolism in the body. This prevents calcium salts from properly depositing in the growing parts of the skeleton, resulting in incomplete mineralization of bone tissue during growth. It produces a systemic, chronic nutritional disease characterized by skeletal lesions and closely related to lifestyle. The primary causes of rickets are due to a combination of factors leading to vitamin D deficiency. Feeding methods, cod liver oil supplementation, living environment, time spent outdoors, recurrent respiratory infections, maternal calcium deficiency during pregnancy, and the season of birth are all significant contributing factors to the incidence of rickets. Generally, most cases of rickets are not inherited to the next generation. However, if there is a clear hereditary disease causing insufficient levels of vitamin D, it could potentially be inherited by the next generation.

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Written by Li Jiao Yan
Neonatology
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Early symptoms of rickets

Rickets is a chronic systemic nutritional disease caused by insufficient vitamin D in the body, leading to disturbances in calcium and phosphorus metabolism, characterized by skeletal lesions, typically presenting as incomplete mineralization of the long bones' growth plates and bone tissue. In the early stages of rickets, skeletal development abnormalities are not very obvious. Infants under three months often exhibit signs of increased neural excitability, such as being prone to crying, sweating easily, and potentially frequent head shaking; however, these symptoms are not necessarily specific to rickets. Generally, at this time, there are no obvious abnormalities in skeletal development, and X-rays of the bones are normal. The focus is on vitamin levels, specifically decreased serum 25-hydroxy vitamin D, as well as reduced blood calcium and phosphorus levels. Therefore, early symptoms are not so typical. It is recommended that children regularly visit pediatric clinics for physical examinations to assess their development and, if necessary, undergo trace element and vitamin D level checks.

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Written by Li Jiao Yan
Neonatology
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How should children with rickets supplement calcium?

Rickets is a nutritional disease caused by a deficiency in vitamin D, leading to disturbances in calcium and phosphorus metabolism in the body, which results in abnormal bone development. It is mainly due to a lack of vitamin D, so the primary treatment is supplementing with vitamin D. Dairy is a reliable source of calcium nutrition for infants, and generally, it is not necessary to supplement calcium for the treatment of rickets; attention should be paid to supplementing with vitamin D according to the severity of the condition, and spending more time in the sun. For children who have started eating complementary foods, or older children, it is generally recommended to fully supplement vitamin D levels, spend more time in the sun during summer, and consume high-protein nutrients. Additionally, eating more vegetables and appropriately supplementing with calcium supplements in the winter is advised. The dosage should be based on the child's internal levels of calcium and phosphorus, with calcium supplementation adjusted accordingly.