Maryam Waheed, Tahir Masood Ahmad.
Vitamin D resistant rickets in children.
Pak Paed J Jan ;21(2):75-80.

Vitamin D resistant rickets is caused by a variety of heritable and acquired conditions. Thus Corm of rickets is a real diagnostic and therapeutic challenge. To find out the pattern of the different types of vitamin D resistant rickets, a study was conducted in the Department of Pediatrics. Postgraduate Medical Institute Lahore and Lahore General Hospital, Lahore for a period of one year from 1st August 1994 to 31st July 1995. A total of 30 children who fulfilled the criteria for vitamin D resistance were included in the study. All the patients were evaluated in detail. The patient`s ages ranged from 0.25 to 12 years (Median age 2.7 years). Most of the cases were seen between I-5 years wish male to female ratio of 1:1.14. About 70% of the patients fell in category of heritable conditions such as familial hypophosphatemia (26.66%), vitamin D dependent rickets type 1 (13.33%) and VDDR-II (6.66%), renal tubular acidosis (13.33%), Bartter syndrome (6.66%) and Fanconi syndrome (3.33%). The acquired conditions seen were renal osteodystrophy (16.66%), rickets due to malabsorption (6.66%), rickets related to anticonvulsants (3.33%) and prematurity (3.33%). In boys, the commonest cause was familial hypophosphatemia (35.71%) followed by renal osteodystrophy (17.64%). In girls the commonest cause was vitamin D dependent rickets type I (25%) followed by familial hypophosphatemia (18.75%). Most of the patients had marked stunting and skeletal deformities. The response to treatment was encouraging in many cases but was poor in renal osteodystrophy and vitamin D dependent rickets type II.

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