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Nutrisyonel Rikets Tanısı Alan Hastaların Değerlendirmesi: Tek Merkez Çalışması

Year 2017, Volume: 11 Issue: 1, 46 - 50, 01.04.2017

Abstract

Amaç: Nutrisyonel rikets önemli bir halk sağlığı problemi olmaya devam etmektedir. Ülkemizde 2005 yılında başlanan ücretsiz D vitamini desteğinden sonra nutrisyonel rikets insidansı azalmış olsa da hala daha önlenebilir hastalıklar arasında yer almaya devam etmektedir. D vitamini suplementasyonu sonrası nutrisyonel rikets tanısı alan hastaları değerlendirmeyi amaçladık.Gereç ve Yöntemler: Çalışmaya nutrisyonel rikets tanısı konulan toplam 93 olgu dahil edildi. Hastaların dosya bilgileri ve laboratuvar tetkikleri retrospektif olarak incelenerek veriler elde edildi.Bulgular: 39’u (41%) kız, 54’ü (%59) erkek olan 93 nutrisyonel riketsli hasta değerlendirildi. Hastaların ortalama yaşı 19±35,1 ay’dı. Fizik muayenede en sık el bilek kemiklerinde genişleme ve raşitik rozari saptandı. En sık bulgu olarak hipokalsemik nöbet (28%, n= 26) saptandı. Hipokalsemi olguların 46%’sında (n= 43) görüldü ve sitos tedavisi olguların 53%’üne uygulandı. Olguların 46%’sında eşlik eden başka bir hastalık vardı. Olgular sıklıkla Şubat ve Mayıs arasında başvurdu ve olguların yalnızca 20%’si D vitamini desteği almaktaydı.Sonuç: 400 IU D vitamini desteği gözden geçirilmeli ve daha yaygın kullanımı sağlanmalıdır.

References

  • Pitt MJ. Rickets and osteomalacia are still around. Radiol Clin North Am 1991;29:97-118.
  • Prentice A. Nutritional rickets around the world. J Steroid Biochem Mol Biol 2013;136:201-6.
  • Hatun S. Vitamin D deficiency and prevention: Turkish experience. J Pediatr Sci 2012;8:4-8.
  • Akpede GO, Omotara BA, Ambe JP. Rickets and deprivation: A Nigerian study. J R Soc Promot Health 1999;119:216-22.
  • Evaluation of the vitamin D intake history of our patients revealed that only 20% were taking vitamin D regularly, meaning that 80%
  • Ladhani S, Srinivasan L, Buchanan C, Allgrove J. Presentation of vitamin D deficiency. Arch Dis Child 2004;89:781-4.
  • Hatun S, Ozkan B, Orbak Z, Doneray H, Cizmecioglu F, Toprak D, et al. Vitamin D deficiency in early infancy. J Nutr 2005;135: 279- 82.
  • Wharton B, Bishop N. Rickets. Lancet 2003;25:1389-400.
  • Ward LM, Gaboury I, Ladhani M, Zlotkin S. Vitamin D-deficiency rickets among children in Canada. CMAJ 2007;177:161-6.
  • Cesur Y. Nutritional rickets. J Pediatr Sci 2012;8:33-41.
  • Doğan M, Erol M, Cesur Y, Yuca SA, Dogan SZ. The effect of 25-hydroxyvitamin D3 on the immune system. J Pediatr Endocrinol Metab 2009;22:929-35.
  • Haider N, Nagie A. Frequency of nutritional rickets in children admitted with severe pneumonia. J Pak Med Assoc 2010;60:729- 32.
  • McNally JD, Leis K, Matheson LA, Karuananyake C, Sankaran K, Rosenberg AM. Vitamin D deficiency in young children with severe acute lower respiratory infection. Pediatr Pulmonol 2009;44:981- 8.
  • Doğan M, Erol M, Cesur Y, Yuca SA, Doğan Z. The effect of 25-hydroxyvitamin D on the immune system. J Pediatr Endocrinol Metab 2009;22:929-35.
  • Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc 2006;81:353-73.
  • Mutlu G, Kusdal Y. Prevention of vitamin D deficiency in infancy: Daily 400 İU vitamin D is sufficient. Int J Pediatr Endocrinol 2011;2011:4.
  • Agarwal KS, Mughal MZ, Upadhyay P, Berry JL, Mawer EB, Puliyel JM. The impact of atmospheric pollution on vitamin D status of infants and toddlers in Delhi, India. Arch Dis Child 2002;87:111-3.
  • Salama MM, El-Sakka AS. Hypocalcemic seizures in breastfed infants with rickets secondary to severe maternal vitamin D deficiency. Pak J Biol Sci 2010;13:437-42.

Evaluation of Patients Diagnosed with Nutritional Rickets: A Single Center Study Nutrisyonel Rikets Tanısı Alan Hastaların Değerlendirmesi

Year 2017, Volume: 11 Issue: 1, 46 - 50, 01.04.2017

Abstract

Objective: Nutritional rickets continues to be an important health care problem. Its incidence has decreased in our country following the free vitamin D distribution that started in 2005 but it continues to stay on the agenda as a preventable disorder. Our aim was to evaluate patients diagnosed with nutritional rickets following the vitamin D supplementation program.Material and Methods: A total of 93 cases diagnosed with nutritional rickets were included in the study. The data were retrospectively collected from patient records and laboratory analyses.results: The 93 nutritional rickets patients we evaluated consisted of 39 (41%) girls and 54 (59%) boys. The mean age was 19.1±35.1 months. The physical examination usually revealed widening of the wrists and rachitic beads. The most common sign at presentation was hypocalcemic seizure (28%, n= 26). Hypocalcemia was present in 46% (n= 43) and single large doses of vitamin D (stoss) therapy had been administered to 53% (n= 49). A concurrent disorder was present in 46%. The patients had presented mostly in February and May and only 20% had been receiving vitamin D supplementation. conclusion: The 400 IU vitamin D supplementation dose needs to be revised and the program made more widely available

References

  • Pitt MJ. Rickets and osteomalacia are still around. Radiol Clin North Am 1991;29:97-118.
  • Prentice A. Nutritional rickets around the world. J Steroid Biochem Mol Biol 2013;136:201-6.
  • Hatun S. Vitamin D deficiency and prevention: Turkish experience. J Pediatr Sci 2012;8:4-8.
  • Akpede GO, Omotara BA, Ambe JP. Rickets and deprivation: A Nigerian study. J R Soc Promot Health 1999;119:216-22.
  • Evaluation of the vitamin D intake history of our patients revealed that only 20% were taking vitamin D regularly, meaning that 80%
  • Ladhani S, Srinivasan L, Buchanan C, Allgrove J. Presentation of vitamin D deficiency. Arch Dis Child 2004;89:781-4.
  • Hatun S, Ozkan B, Orbak Z, Doneray H, Cizmecioglu F, Toprak D, et al. Vitamin D deficiency in early infancy. J Nutr 2005;135: 279- 82.
  • Wharton B, Bishop N. Rickets. Lancet 2003;25:1389-400.
  • Ward LM, Gaboury I, Ladhani M, Zlotkin S. Vitamin D-deficiency rickets among children in Canada. CMAJ 2007;177:161-6.
  • Cesur Y. Nutritional rickets. J Pediatr Sci 2012;8:33-41.
  • Doğan M, Erol M, Cesur Y, Yuca SA, Dogan SZ. The effect of 25-hydroxyvitamin D3 on the immune system. J Pediatr Endocrinol Metab 2009;22:929-35.
  • Haider N, Nagie A. Frequency of nutritional rickets in children admitted with severe pneumonia. J Pak Med Assoc 2010;60:729- 32.
  • McNally JD, Leis K, Matheson LA, Karuananyake C, Sankaran K, Rosenberg AM. Vitamin D deficiency in young children with severe acute lower respiratory infection. Pediatr Pulmonol 2009;44:981- 8.
  • Doğan M, Erol M, Cesur Y, Yuca SA, Doğan Z. The effect of 25-hydroxyvitamin D on the immune system. J Pediatr Endocrinol Metab 2009;22:929-35.
  • Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc 2006;81:353-73.
  • Mutlu G, Kusdal Y. Prevention of vitamin D deficiency in infancy: Daily 400 İU vitamin D is sufficient. Int J Pediatr Endocrinol 2011;2011:4.
  • Agarwal KS, Mughal MZ, Upadhyay P, Berry JL, Mawer EB, Puliyel JM. The impact of atmospheric pollution on vitamin D status of infants and toddlers in Delhi, India. Arch Dis Child 2002;87:111-3.
  • Salama MM, El-Sakka AS. Hypocalcemic seizures in breastfed infants with rickets secondary to severe maternal vitamin D deficiency. Pak J Biol Sci 2010;13:437-42.
There are 18 citations in total.

Details

Other ID JA72YH26FM
Journal Section Research Article
Authors

Melikşah Keskin This is me

Meryem Karaca This is me

Zehra Aycan This is me

Semra Çetinkaya This is me

Publication Date April 1, 2017
Submission Date April 1, 2017
Published in Issue Year 2017 Volume: 11 Issue: 1

Cite

Vancouver Keskin M, Karaca M, Aycan Z, Çetinkaya S. Evaluation of Patients Diagnosed with Nutritional Rickets: A Single Center Study Nutrisyonel Rikets Tanısı Alan Hastaların Değerlendirmesi. Türkiye Çocuk Hast Derg. 2017;11(1):46-50.


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