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Rickets

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Definition:

Rickets is a disorder primarily caused by lack of vitamin D, calcium, or phosphate, which leads to softening and weakening of the bones.

Alternative Names:

Osteomalacia in children; Vitamin D deficiency; Renal rickets

Causes, incidence, and risk factors:

Vitamin D helps the body properly control calcium and phosphate levels in the body. When the body is deficient in vitamin D, it is unable to properly control calcium and phosphate levels. If the blood levels of these minerals become too low, the body may produce other body hormones to stimulate release of calcium and phosphate from the bones. This leads to weak and soft bones.

Vitamin D may be absorbed from food or may be produced by the skin when the skin is exposed to sunlight. Lack of vitamin D production by the skin may occur in people who must stay indoors, work indoors during the daylight hours, or live in climates with little exposure to sunlight.

Because vitamin D is a fat-soluble vitamin, malabsorption disorders that reduce digestion or absorption of fats will decrease the ability of vitamin D to be absorbed into the body.

You may not get enough Vitamin D from your diet if you follow a vegetarian diet, do not drink milk products, or are lactose intolerant (have trouble digesting milk products). Infants who are exclusively breastfed may develop vitamin D deficiency. Human breast milk does not supply the proper amount of vitamin D. This can be a particular problem for darker-skinned children in winter months (when there are lower levels of sunlight).

Not getting enough calcium and phosphorous in your diet can also lead to rickets. Rickets caused by a dietary lack of these minerals is rare in developed countries because calcium and phosphorous are found in milk and green vegetables.

Your genes may increase your risk of rickets. Hereditary rickets is form of the disease that is passed down through families. It occurs when the kidneys are unable to retain the mineral phosphate. Rickets may also be caused by kidney disorders that involve renal tubular acidosis.

Occasionally, rickets may also occur in children who have disorders of the liver, or cannot convert vitamin D to its active form.

Rickets is rare in the United States. It is most likely to occur during periods of rapid growth, when the body demands high levels of calcium and phosphate. Rickets may be seen in young children 6 to 24 months old and is uncommon in newborns.

• Review Date: 8/18/2006
• Reviewed By: Benjamin W. Van Voorhees, MD, MPH, Assistant Professor of Medicine and Pediatrics, The University of Chicago, Chicago, IL. Review provided by VeriMed Healthcare Network.

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