Abstract Ref Number = APCP1134
DEFICIENCY VITAMIN D CAUSES RICKETS IN 11 YEARS OLD GIRL A CASE REPORT
Anggia Rarasati Wardhana,Annisa Muhyi
Department of Child Health University of Mulawarman Medical School A W Sjahranie Hospital Samarinda Indonesia Department of Child Health, University of Mulawarman Medical School, AW Sjahranie Hospital, SamarindaIndonesia
Background : Rickets is a condition that causes children to have soft, weak bones caused by defective mineralization of bones. It characterized by a failure or delay in endochondral calcification of the growth plates of long bones. It remains a major public health problem, despite dramatic declines in many countries since the discovery of vitamin D and the role of ultraviolet light in prevention. With the aid of sunlight exposure, human synthesize vitamin D in the skin. Rickets which is rare in the last decade, usually unexpected in a sun-rich country like Indonesia. It is distinct from other types of rickets, that is merely caused by a simple deficiency in vitamin D and thus can be easily corrected if detected early. This case determined a nutritional rickets in a sun rich country.
Case Presentation Summary : A 11 years old girl with a chief complaint of bone pain on feet since she was 2 years old and getting worse for last 2 weeks. It had widening wrists and ankles, and difficult in walking. She had been treated and got physiotherapy at the age of 5 years. Physical exams revealed widening of wrists and ankles, and short stature. Early diagnosis for this patient was rickets and differential diagnosis was osteogenesis imperfecta. The blood of vitamin D was 9,4 mg/mL, alkaline phosphatase 2121 U/L, calcium 7,7 mg/dl, and LDH 476 U/L. The X-rays of knees showed bowing on bilateral tibia with proximal and distal epiphysis widening of bilateral tibia. She was treated with calcium carbonate and vitamin D.
Learning Points/Discussion : Diagnosis of rickets is established by clinical, laboratory, and X-ray examinations. Patient was treated with calcium carbonate 30-75 mg/kg/day and vitamin D 2000 IU/day.
Keywords: Rickets calcium carbonate vitamin D