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Review
. 2021 Jun 27;9(7):738.
doi: 10.3390/biomedicines9070738.

Rickets in Children: An Update

Cristina Gentile  1 , Francesco Chiarelli  1
Affiliations
Review

Rickets in Children: An Update

Cristina Gentile et al. Biomedicines. .

Abstract

Rickets refers to a deficient mineralization of the growth plate cartilage, predominantly affecting longer bones. Despite the fact that preventive measures are available, it is still a common disease worldwide; nutritional rickets, due to vitamin D deficiency or dietary calcium inadequate intake, remains the most common form. Medical history, physical examination, radiologic features and biochemical tests are essential for diagnosis. Although recent studies suggest hypophosphatemia as the leading alteration, rickets is classically divided into two categories: calcipenic rickets and phosphopenic rickets. Knowledge of this categorization and of respective clinical and laboratory features is essential for rapid diagnosis and correct management. The aim of this review is to analyze the epidemiological, pathogenetic, clinical, and therapeutic aspects of the different forms of rickets, describing the novelties on this "long-lived" disease.

Keywords: FGF-23; X-linked hypophosphatemic rickets; burosumab; calcipenic rickets; phosphopenic rickets; rickets; vitamin D.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Metabolism of vitamin D.
Figure 2
Figure 2
PTH/FGF23/1,25(OH)2D interaction.
Scheme 1
Scheme 1
Clinical features.
Scheme 2
Scheme 2
VDDR1: Vitamin D Dependent Rickets type 1; VDDR2: Vitamin D Dependent Rickets type 2; TmPi/GFR: tubular maximum reabsorption of phosphate (TmP) to GFR; TRP: tubular reabsorption of phosphate; XLHR: X-Linked Hypophosphatemic Rickets; ARHR: Autosomal Recessive Hypophosphatemic Rickets; ADHR: Autosomal Dominant Hypophosphatemic Rickets; HHRH: Hereditary Hypophosphatemic Rickets with Hypercalciuria.
See this image and copyright information in PMC

References

    1. Whistler D. Morbo Puerile Anglorum, Quem Patrio Idiomate Indigenae Vocant the Rickets. Ex Officinâ Wilhelmi Christiani Boxii; Lugduni Batavorum, The Netherlands: 1645. pp. 1–13.
    1. Callaghan A.L., Moy R.J., Booth I.W., Debelle G., Shaw N.J. Incidence of symptomatic vitamin D deficiency. Arch. Dis. Child. 2006;91:606–607. doi: 10.1136/adc.2006.095075. - DOI - PMC - PubMed
    1. Lambert A.S., Linglart A. Hypocalcaemic and hypophosphatemia rickets. Best Pract. Res. Clin. Endocrinol. Metab. 2018;32:455–476. doi: 10.1016/j.beem.2018.05.009. - DOI - PubMed
    1. Chanchlani R., Nemer P., Sinha R., Nemer L., Krishnappa V., Sochett E., Safadi F., Raina R. An Overview of Rickets in Children. Kidney Int. Rep. 2020;5:980–990. doi: 10.1016/j.ekir.2020.03.025. - DOI - PMC - PubMed
    1. Sabbagh Y., Carpenter T.O., Demay M.B. Hypophosphatemia leads to rickets by impairing caspase-mediated apoptosis of hypertrophic chondrocytes. Proc. Natl. Acad. Sci. USA. 2005;102:9637–9642. doi: 10.1073/pnas.0502249102. - DOI - PMC - PubMed

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