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Paper Information

Journal:   ARCHIVES OF IRANIAN MEDICINE   December 2018 , Volume 21 , Number 12; Page(s) 589 To 594.
 
Paper: 

Children With Vitamin D Deficiency: Is A Wrist X-Ray Necessary?

 
 
Author(s):  ESMAEILIDOOKI MOHAMMADREZA, MOSLEMI LEILA*, MOGHADAMNIA ALI AKBAR, ALIJANPOUR AGHAMALEKI MORTEZA, BIJANI ALI, Pornasrollah Mohammad, ASHRAFIAN AMIRI HASSAN, NOOREDDINI HAJI GHORBANN
 
* Non Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, No 19, Amirkola Children’s Hospital, Amirkola, Babol, Mazandaran Province, 47317-41151, IR Iran
 
Abstract: 
Background: Rickets is failure in mineralization of growing bone and cartilage due to extreme vitamin D deficiency (VDD). The study aimed to identify rickets among vitamin D deficient children and determine any relationship between clinical findings and paraclinical evidence. Methods: This study was conducted in two stages. In the first stage, blood was drawn from 406 children aged 30– 72 months for measurement of 25(OH)D level. Of these children, 108 had 25(OH)D levels of <20 ng/dL and were evaluated physically for signs and symptoms scores (0-1) of VDD and rickets. Biochemical analysis and radiography of the child’ s left wrist and hand was performed. Results: Of the 119 children (29. 67%) with 25(OH)D levels of <20 ng/dL, 42 (10. 3%) had vitamin D levels of ≤ 15 ng/dL. There was no correlation between serum 25(OH)D level and levels of calcium (Ca) (r = − 0. 16), alkaline phosphatase (ALP) (r = − 0. 12), P (r = 0. 13), and parathyroid hormone (PTH) (r = − 0. 15, ) in children with VDD. The mean of signs and symptoms scores had no significant difference between children with (1. 59 ± 0. 8) and without (1. 73 ± 1. 01) VDD (P = 0. 3). None of the children with VDD had radiographic evidence of rickets. Radiographic data showed that 69. 2% (72), 10. 6% (11), and 20. 2% (21) of the children had delayed, normal, and advanced bone age, respectively. Conclusion: Abnormal radiological findings of rickets were not found on wrist X-rays. Thus, this investigation is not necessary within the range of vitamin D levels described in the current study.
 
Keyword(s): Children,Radiography,Rickets,Vitamin D deficiency
 
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