Dental manifestations of pseudo-vitamin-D deficiency rickets in a paediatric patient

Vitamin D–resistant rickets shows the resistance to vitamin D (Vit-D) therapy, which traditionally works well in cases with deficiency rickets. The signs start appearing as early as in the first month of life and are characterised by the defective mineralisation at the ends of cartilage and bones despite having normal Vit-D levels in the serum. This case report highlights the dental and maxillofacial manifestations in a 3-year-old girl diagnosed with pseudo-Vit-D deficiency rickets. The report also highlights the variations in the dental manifestations of the condition reported in the literature.

Delayed fracture union in a case of vitamin D dependent rickets associated with pulmonary tuberculosis - a case report

<p>Rickets is a defect of bone mineralization caused by vitamin D deficiency, seen most significantly at growth plates that result in radiological bony abnormalities like metaphyseal flaring and cupping, physeal widening with focal and generalised osteomalacia.<strong> </strong>Here we present a rare case of 7 years old male, a case of vitamin D3 deficiency rickets in a known case of multi drug resistant pulmonary tuberculosis. The patient had suffered left proximal fibular fracture following trivial fall 1.5 month back and had delayed bony union leading to difficulty in walking and pain. The patient was treated with oral vitamin D supplementation. In vitamin D deficiency rickets, there is decreased bone mineralization leading to weak bones and delayed fracture healing in children. Low serum vitamin D levels also caused decreased immunity with increased susceptibility to respiratory infections like pulmonary tuberculosis. Appropriate treatment with injectable or oral vitamin D3 with adequate exposure of sunlight and proper nutrition is the best modality of treatment.<strong></strong></p><p><strong> </strong></p>

THE ROLE OF OBESIT Y IN THE DE VELOPMENT OF VITAMIN D DEFICIENCY RICKETS IN CHILDREN

Vitamin D deficiency rickets is one of the most common diseases among children of the first years of life in many countries around the world. It is very important to understand the aforementioned nosological unit as a metabolism disorder, and not just as a D-deficiency state. In modern conditions, the risk factors for vitamin D deficiency rickets have undergone further study. The results of the research indicate that obesity is one of the risk factors for vitamin D deficiency in children. Thus, vitamin D metabolism, deposition, bioavailability and its biological role are dependent on the size of adipose tissue. The pathogenetic interaction between obesity andМvitamin D deficiency is probably predetermined by several mechanisms. Firstly, in case of obesity, vitamin D,Мwhich is a fat-soluble substance, is distributed in a considerable amount of adipose tissue, which leads toa decrease in its concentration in the blood plasma. Secondly, with excessive body weight there is a limitation of vitamin D bioavailability, caused by vitamin D capture with adipocytes and depositing in adipose tissue.Thirdly, there is a genetic proof that the increase in BMI leads to a decrease in vitamin D levels in blood serum.Recent studies have shown that adipose tissue may be the direct target of vitamin D physiological actions.It has been proved that vitamin D can affect obesity through numerous mechanisms, including protein expression, oxidative stress, inflammation and cellular metabolism. Currently, recommendations for treatment and prevention of vitamin D deficiency can be found in international foreign guidebooks whose authors state that obese children need a higher dosage of vitamin D compared to those whose physical development is consistent with age. Understanding the influence of adipose mass on bone tissue during its growth and development is a very important aspect for further health and pharmacotherapy strategies to prevent bone disorders.

Vitamin D Deficiency Rickets and COVID-19 Pandemic

In a breastfed infant, the main source of vitamin D comes from the mother. Thus, maternal vitamin D deficiency is the key reason for vitamin D deficiency (VDD) and rickets during infancy. As they grow older, inadequate sun exposure, diet and lack of supplements also contribute. Individuals with darker skin require at least three to five times longer exposure to the sun than a person with lighter skin to produce adequate endogenous vitamin D. Not many food items naturally contain vitamin D; most of those are less affordable to the poor. We report an 18-month-old child with vitamin D deficiency rickets during strict self-isolation measures during the coronavirus disease 2019 (COVID-19) pandemic. Prolonged periods of confining indoors, low dietary intake of vitamin D, economic distress, maternal deficiency, and nonsupplementation could have contributed to vitamin D deficiency rickets in this child. During an unprecedented pandemic of this nature, simple sun exposure and diet advice may suffice for most. This case report highlights the importance of strengthening individuals and communities with information and formulating strong public health policies to prevent vitamin D deficiency.