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Article Type

Original Study

Abstract

Objectives The aim of this study was to assess clinical findings in different types of rickets, nutritional or resistant rickets. Background Rickets is a metabolic disease of growth plate mineralization and ossification commonly occurring in children and adolescents. Vitamin D deficiency may result in bone diseases, such as rickets in children and osteomalacia and osteoporosis in adults. Patients and methods This study included 100 cases that presented with rickets in the rickets outpatient clinic of the National Institute of Neuromotor System. The initial search presented 100 cases of rickets aged from 4 months to adolescence. Cases less than 4 months of age or those above 18 years of age or with other bone diseases such as osteogenesis imperfecta, and hyperparathyroidism cases were excluded from the study. Comparisons were made by means of structured review with the results tabulated. Results Of the 100 cases, 85% of cases were nutritional, whereas refractory rickets represented 15% of our cases. The incidence of refractory rickets was as follows: 26.7% hypophosphatemic rickets, 20% vitamin D-dependent type II, 20% vitamin D-dependent type I, 6.7% renal osteodystrophy, 13.3% renal tubular acidosis, 6.7% Fanconi syndrome, and 6.7% hypophosphatasia. Conclusion We found that the most common nonnutritional form of rickets was hypophosphatemic rickets. These results indicate the necessity to look for the diagnosis of renal tubular acidosis and hypophosphatemic rickets among children with rickets, especially in older-aged children, those with severe clinical features and poor response to therapy.

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