Rickets is a decease affecting young growing children, associated with violation of metabolism and deficiency of vitamin D. It affects bones and nervous systems.
Rickets was known in ancient times. In the second century, BC Soranus of Ephesus and Galen described the rachitic changes in the skeletal system. In XV-XVI centuries, rickets was a fairly common disease among young children, especially from the large (for the time) European cities. No coincidence that many well-known, Dutch, Flemish, German and Danish artists of the time often portrayed children with typical signs of rickets in their works (overhanging eyebrows, a flattened head, sprawled belly, twisted limbs, etc). Even now, rickets is a fairly common disease. In the past 50 years the rickets rates actually got higher. The British scientists held the research and revealed, that the case of rickets are 3,16 in 100 000 babies compared to 0,34 of the early 2000-ies, while more than 20 % of babies have signs of vitamin D deficiency. That goes to those who live in northern regions and major polluted cities. Children in rural area and those who live in southern regions are less common to have rickets.
Vitamin D group unlike other vitamins is not only contained in the food, but is also produced in the skin under the influence of sunlight and artificial UV irradiation. The most important of the D group is D3 (cholecalciferol). Vitamin D regulates calcium and phosphor metabolism and is necessary for normal bone formation. It increases the absorption of those minerals, promotes their assimilation and deposition in the bones. Accordingly there are basic factors causing the rickets:
- Lack of staying under the sun (ultraviolet flaw) – the risk of rickets is increased in winter;
- Insufficiency of vitamin D in the food and deficiency of minerals;
- Consumption of anticonvulsants;
- Violated absorbing of Vitamin D during some deceases.
What are the symptoms?
- Lack of vitamin D (D-vitamin deficiency) in children leads to rickets, in older age people – to osteoporosis and osteomalacia. Vitamin D deficiency is particularly widespread among young children. The initial symptoms of rickets are associated with damage to the nervous system;
- Sleep disturbance (surface or trouble sleeping);
- Increased tearfulness;
- Excessive sweating and occipital baldness. Sweating may be so intensive that when a child is asleep the wet spot around his head may be noted (so called syndrome of wet pillow). The sticky sweat causes skin irritation and the sweating itself causes child to worry. That’s where the rubbing the forehead on the pillow comes from. Almost always rickets is accompanied with a muscular hypotonia – muscle weakness, which is often admitted by child parents. In addition, the so-called «frog» belly may be observed. Children suffering from rickets are noted to have delayed closure of the fonticulus and delayed eruption of deciduous teeth. The teeth may also erupt in a wrong order. In the future the teeth of children with rickets are likely to be affected by cavities or hypoplasia (softening and damaging) of enamel. With further development of decease the bones, chest, skull, extremities and spine get affected.
Typical bones deformations in rickets:
- X-shaped and O-shaped legs;
- Pelvic bone deformation in girls, which in the future may become an obstacle for normal childbirth;
- “Olympic forehead” – overgrown parietal and frontal mounds due to softening of the skull bones;
- The head gets cube shape, the skull becomes large;
- Thickening of the ribs in the place where the bone tissue transforms to cartilage;
- The pressing of the lower chest (so called cobblers chest). In cases of severe form of rickets the protrusion of the chest (so called chicken breast) may be observed. With further development of the disease can affect internal organs (liver, spleen, etc.).
Symptoms of the severe rickets:
- Frequent vomiting;
- Stomach ache;
- Diarrhea or constipations;
- Liver size increase;
- Pallor of the skin that occurs due to anemia.
Rickets often leads to delayed development in infants. Children appear to be late at starting to hold the head straight, to walk, crawl and stand. In some cases when rickets develops after the age of one year the child may become unable to walk. Rickets should be treated right away. If the disease has been developing long enough – the consequences may be observed for the rest of the life. This disease can contribute to the development of scoliosis, flat feet, pelvis deformation (“flat basin”), X or O-shaped legs. At school age myopia can develop. The rickets disease is diagnosed by pediatrician.