AIM: To define the demographics and clinical characteristics of cases presenting with nutritional rickets to paediatric centres in Sydney, Australia. METHODS: Retrospective descriptive study of 126 cases seen from 1993 to 2003 with a diagnosis of vitamin D deficiency and/or confirmed rickets defined by long bone x ray changes. RESULTS: A steady increase was seen in the number of cases per year, with a doubling of cases from 2002 to 2003. Median age of presentation was 15.1 months, with 25% presenting at less than 6 months of age. The most common presenting features were hypocalcaemic seizures (33%) and bowed legs (22%). Males presented at a younger age, with a lower weight SDS, and more often with seizures. The caseload was almost exclusively from recently immigrated children or first generation offspring of immigrant parents, with the region of origin predominantly the Indian subcontinent (37%), Africa (33%), and the Middle East (11%). Seventy nine per cent of the cases were born in Australia. Eleven cases (all aged <7 months) presented atypically with hyperphosphataemia. CONCLUSIONS: This large case series shows that a significant and increasing caseload of vitamin D deficiency remains, even in a developed country with high sunlight hours. Cases mirror recent immigration trends. Since birth or residence in Australia does not appear to be protective, screening of at risk immigrant families should be implemented through public health policies.
AIM: To define the demographics and clinical characteristics of cases presenting with nutritional rickets to paediatric centres in Sydney, Australia. METHODS: Retrospective descriptive study of 126 cases seen from 1993 to 2003 with a diagnosis of vitamin D deficiency and/or confirmed rickets defined by long bone x ray changes. RESULTS: A steady increase was seen in the number of cases per year, with a doubling of cases from 2002 to 2003. Median age of presentation was 15.1 months, with 25% presenting at less than 6 months of age. The most common presenting features were hypocalcaemic seizures (33%) and bowed legs (22%). Males presented at a younger age, with a lower weight SDS, and more often with seizures. The caseload was almost exclusively from recently immigrated children or first generation offspring of immigrant parents, with the region of origin predominantly the Indian subcontinent (37%), Africa (33%), and the Middle East (11%). Seventy nine per cent of the cases were born in Australia. Eleven cases (all aged <7 months) presented atypically with hyperphosphataemia. CONCLUSIONS: This large case series shows that a significant and increasing caseload of vitamin D deficiency remains, even in a developed country with high sunlight hours. Cases mirror recent immigration trends. Since birth or residence in Australia does not appear to be protective, screening of at risk immigrant families should be implemented through public health policies.
Authors: Rosalyn Singleton; Rachel Lescher; Bradford D Gessner; Matthew Benson; Lisa Bulkow; John Rosenfeld; Timothy Thomas; Robert C Holman; Dana Haberling; Michael Bruce; Michael Bartholomew; James Tiesinga Journal: J Pediatr Endocrinol Metab Date: 2015-07 Impact factor: 1.634
Authors: Craig F Munns; Nick Shaw; Mairead Kiely; Bonny L Specker; Tom D Thacher; Keiichi Ozono; Toshimi Michigami; Dov Tiosano; M Zulf Mughal; Outi Mäkitie; Lorna Ramos-Abad; Leanne Ward; Linda A DiMeglio; Navoda Atapattu; Hamilton Cassinelli; Christian Braegger; John M Pettifor; Anju Seth; Hafsatu Wasagu Idris; Vijayalakshmi Bhatia; Junfen Fu; Gail Goldberg; Lars Sävendahl; Rajesh Khadgawat; Pawel Pludowski; Jane Maddock; Elina Hyppönen; Abiola Oduwole; Emma Frew; Magda Aguiar; Ted Tulchinsky; Gary Butler; Wolfgang Högler Journal: J Clin Endocrinol Metab Date: 2016-01-08 Impact factor: 5.958