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Management of a child with rickets Author Martina Lazăr Coauthor Anca Liana Leuca Coordinator Assistant Professor Zsuzsanna Gall
18

Management of a child with rickets Author Martina Lazăr Coauthor Anca Liana Leuca Coordinator Assistant Professor Zsuzsanna Gall.

Jan 12, 2016

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Page 1: Management of a child with rickets Author Martina Lazăr Coauthor Anca Liana Leuca Coordinator Assistant Professor Zsuzsanna Gall.

Management of a child with rickets

Author Martina LazărCoauthor Anca Liana LeucaCoordinator Assistant Professor Zsuzsanna Gall

Page 2: Management of a child with rickets Author Martina Lazăr Coauthor Anca Liana Leuca Coordinator Assistant Professor Zsuzsanna Gall.

Introduction

• Rickets is a disease of growing bone that is unique to children and teenagers. It is caused by a failure of osteoid to calcify in a growing person.

Page 3: Management of a child with rickets Author Martina Lazăr Coauthor Anca Liana Leuca Coordinator Assistant Professor Zsuzsanna Gall.

Introduction

• Vitamin D is a key hormone in the regulation of calcium and phosphorus metabolism and plays a principal role in bone health, particularly during pediatric age when nutritional rickets and impaired bone mass acquisition may occur.

Page 4: Management of a child with rickets Author Martina Lazăr Coauthor Anca Liana Leuca Coordinator Assistant Professor Zsuzsanna Gall.

Ethiology

• There are many causes of rickets, including – vitamin D deficiency, inadecvated diet, – calcium deficiency, – phosphorous deficiency, – distal renal tubular acidosis, – insufficient exposure to UV, and – medications.

Page 5: Management of a child with rickets Author Martina Lazăr Coauthor Anca Liana Leuca Coordinator Assistant Professor Zsuzsanna Gall.

Purpose

The purpose of this study is to evaluate the patient with rickets

depending on epidemiological,

clinical and paraclinical data .

Page 6: Management of a child with rickets Author Martina Lazăr Coauthor Anca Liana Leuca Coordinator Assistant Professor Zsuzsanna Gall.

Material and Methods

This is a retrospective study over a period of two years, on a group of 105 children of different ages diagnosed with rickets and hospitalized in 2nd Pediatric Department in Targu-Mures, between January 2013 and December 2014.

Page 7: Management of a child with rickets Author Martina Lazăr Coauthor Anca Liana Leuca Coordinator Assistant Professor Zsuzsanna Gall.

Results

• Provenience– The majority of the patients were from rural

area.

Page 8: Management of a child with rickets Author Martina Lazăr Coauthor Anca Liana Leuca Coordinator Assistant Professor Zsuzsanna Gall.

Results

• The rickets affected predominantly males.

Page 9: Management of a child with rickets Author Martina Lazăr Coauthor Anca Liana Leuca Coordinator Assistant Professor Zsuzsanna Gall.

Results• Although more studies showed, that prematurity and low

weight at born are predisposing factors, in our study, they were present in 11,43%, respectively 12,38% .

Page 10: Management of a child with rickets Author Martina Lazăr Coauthor Anca Liana Leuca Coordinator Assistant Professor Zsuzsanna Gall.

Results

• Corresponding to the data from the specialty literature, majority of affected children were newborns, infants and young children. The average age of the patients was 1 year and 4 months in my study.

Page 11: Management of a child with rickets Author Martina Lazăr Coauthor Anca Liana Leuca Coordinator Assistant Professor Zsuzsanna Gall.

Results

• Hypotrophy and distrophy stature-weight are another contributing factors for rickets. In the study group, only 12,4% of children present hypotrophy and 8,6% distrophy.

Page 12: Management of a child with rickets Author Martina Lazăr Coauthor Anca Liana Leuca Coordinator Assistant Professor Zsuzsanna Gall.

Results

• Associated diagnosis

Page 13: Management of a child with rickets Author Martina Lazăr Coauthor Anca Liana Leuca Coordinator Assistant Professor Zsuzsanna Gall.

Clinical features

• Frontal bossing, kyphosis, enlargement of wrist, depressed ribs

Page 14: Management of a child with rickets Author Martina Lazăr Coauthor Anca Liana Leuca Coordinator Assistant Professor Zsuzsanna Gall.

Clinical features

• Harrison groove

• Rachitic rosary

• Delayed dentition

Page 15: Management of a child with rickets Author Martina Lazăr Coauthor Anca Liana Leuca Coordinator Assistant Professor Zsuzsanna Gall.

Conclusion

• After processing the data, we obtained the following results: – the rickets affected 62,86% of boys, – referring to the environment, 64.8% were originated

from rural area, – prematurity was present in 11,43% and low weight

at born in 12,38% of cases. – 21% of children present hypotrophy and distrophy

and majority of children presents associated diagnosis.

Page 16: Management of a child with rickets Author Martina Lazăr Coauthor Anca Liana Leuca Coordinator Assistant Professor Zsuzsanna Gall.

Conclusion

• This study in 2nd Pediatric Department in Targu-Mures has shown that all these favoring factors were not statistically significant . By interpretating this results we have reached the conclusion that the administration of vitamine D was incorectly efectuated in most of the patients.

• Rickets is a very common disease, although exists an accessible and affordable prevention mode. The rickets can be associated with other diseases, some of them with severe prognosis. 

Page 17: Management of a child with rickets Author Martina Lazăr Coauthor Anca Liana Leuca Coordinator Assistant Professor Zsuzsanna Gall.

Prevention

• The most effective ways of prophylaxy are:– Sun exposure– Aerotherapy– Variate alimentation – Administation of calcium and– vitamine D

Page 18: Management of a child with rickets Author Martina Lazăr Coauthor Anca Liana Leuca Coordinator Assistant Professor Zsuzsanna Gall.

The best treatment is prevention.

Thank you!