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

2. 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.

3. 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.

4. 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.

5. Purpose The purpose of this study is to evaluate the patient with rickets depending on epidemiological, clinical and paraclinical data.

6. 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.

7. Results Provenience –The majority of the patients were from rural area.

8. Results The rickets affected predominantly males.

9. 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%.

10. 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.

11. 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.

12. Results Associated diagnosis

13. Clinical features Frontal bossing, kyphosis, enlargement of wrist, depressed ribs

14. Clinical features Harrison groove Rachitic rosary Delayed dentition

15. 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.

16. 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.

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

18. The best treatment is prevention. Thank you!