Abstract
Amaç: Nutrisyonel rikets, D vitamini destek programlarına karşın halen dünya genelinde önemli ve önlenebilir bir halk sağlığı sorunu olmaya devam etmektedir. Yazıda 2011-2015 yılları arasında çocuk endokrinoloji polikliniğimizde izlediğimiz 14 nutrisyonel riketsli olgunun klinik, laboratuvar ve radyolojik bulgularını değerlendirmeyi amaçladık.Gereç ve Yöntemler: Dr. Sami Ulus Kadın Doğum, Çocuk Sağlığı ve Hastalıkları Eğitim ve Araştırma Hastanesi Çocuk Endokrin Kliniği’nde 2011- 2015 yılları arasında nutrisyonel rikets tanısı alan 14 olgu değerlendirildi.Bulgular: Ondört nutrisyonel riketsli olgunun yaş ortalaması 14.3 ±7.3 (4-28) aydı. Hastaların 9’ u (%64) erkek, 5’ i (%36) kız’dı. D vitamini profilaksisi 6 hastada hiç kullanılmamış, 6 hastada ise düzensiz kullanılmıştı. Beş hastanın hipokalsemisi, 8 hastanın hipofosfatemisi vardı ve tüm olguların alkalen fosfataz ve parathormon değerleri yüksekti. Bir hasta hariç tüm hastaların 25 (OH) vitamin D düzeyleri 20 ng/ml’nin altında idi. Hastaların tümünde el bilek grafisinde radius ve ulna distal metafizinde düzensizleşme ve çanaklaşma mevcuttu. Beş hastaya stoss tedavisi, 8 hastaya uzun süreli D vitamini tedavisi verildi. Bir olgu tedaviyi reddetti. Tedavi sonrası tüm olgularda klinik ve radyolojik düzelme gözlendi.Sonuç: Ülkemizde uygulanan D vitamini profilaksisine rağmen nutrisyonel rikets halen görülmektedir. Nutrisyonel riketsli olgularımızın önemli bir kısmında D vitamininin kullanılmadığı veya düzensiz kullanıldığı tespit edilmiştir. Bu nedenle özellikle süt çocukluğu döneminde D vitamini destek programına uyumun artırılması nutrisyonel riketsin önlenmesinde önemli olacaktır.
References
- E Torun, S Bayraktar, E Gönüllü. Nütrisyonel rahitis ve D vitamininin önemi: Vaka sunumu. J Child 2011;11:181-4.
- Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, et al. Global consensus recommendations on prevention and management of nutritional rickets. Horm Res Paediatr 2016;85:83- 106.
Abstract
Objective: Nutritional rickets is a major public health problem throughout the world. Although vitamin D supplementation program has been applied in our country, it is still an important health problem. Accordingly, this study aims to determine clinical, laboratory and radiological characteristics of 14 patients with nutritional rickets followed by the endocrinology clinic between 2011 and 2015.Material and Methods: Fourteen patients who diagnosis with nutritional rickets in Dr. Sami Ulus Obstetrics and Gynecology, Children’s Health and Disease Training and Research Hospital Peadiatric Endocrine Clinic between 20112015 were evaluated.Results: The mean age of the fourteen cases with nutritional rickets was 14.3 ± 7.3 months. Nine (64%) of the patients were male and five (36%) were female. Vitamin D prophylaxis had never been used in 6 patients whereas it has been used irregularly in 6 patients. Additionally, five patients had hypocalcemia and 8 patients had hypophosphatemia. Alkaline phosphatase and parathyroid hormone levels were higher than normal levels in all cases. In all patients except for one, 25 (OH) vitamin D levels were below 20 ng/mL. Wrist radiographs of all patients had irregular metaphyseal distal radius and ulna irregularity and cupping. Six patients were treated with stoss therapy, 7 patients were treated with longterm vitamin D. One patient refused treatment. After treatment all cases showed clinical and radiological improvement.conclusion: Although vitamin D prophylaxis had been recommended to our patients, we still observed nutritional rickets. This is due to the fact that a significant proportion of our patients did not use vitamin D completely or used it irregularly. Therefore, improving compliance with the vitamin D supplementation program in infancy is essential for the prevention of nutritional rickets
References
- E Torun, S Bayraktar, E Gönüllü. Nütrisyonel rahitis ve D vitamininin önemi: Vaka sunumu. J Child 2011;11:181-4.
- Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, et al. Global consensus recommendations on prevention and management of nutritional rickets. Horm Res Paediatr 2016;85:83- 106.
Details
| Other ID | JA32GV82ZT |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | June 1, 2017 |
| Submission Date | June 1, 2017 |
| Published in Issue | Year 2017 Volume: 11 Issue: 2 |
The publication language of Turkish Journal of Pediatric Disease is English.
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