Approach to Rickets: Is It Calciopenic or Phosphopenic?


Abseyi S. N., ŞIKLAR Z.

Turkish Archives of Pediatrics, cilt.58, sa.5, ss.458-466, 2023 (ESCI, Scopus, TRDizin) identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 58 Sayı: 5
  • Basım Tarihi: 2023
  • Doi Numarası: 10.5152/turkarchpediatr.2023.23050
  • Dergi Adı: Turkish Archives of Pediatrics
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.458-466
  • Anahtar Kelimeler: Calcium metabolism, FGF2, Rickets, Vitamin D
  • Ankara Üniversitesi Adresli: Evet

Özet

Rickets is a childhood disorder of decreased mineralization of bone tissue. It is either calcio-penic or phosphopenic, according to the deficient mineral. Calcium, phosphate, and vitamin D metabolism should be known to understand the pathophysiology of rickets. A deficiency of calcium or vitamin D can be caused by several conditions. These conditions lead to defective oste-oid mineralization, impaired chondrocyte differentiation, and apoptosis in the growth plate, resulting in clinical and radiological findings of rickets. Rickets developing as a result of vitamin D deficiency is the most frequently encountered form. Vitamin D-dependent rickets classification is made according to genetic abnormalities of enzymes that are involved in vitamin D metabolism. Phosphopenic rickets is divided mainly into 2 categories that are FGF23 related or not. A systemic approach that includes a detailed history, physical examination, and laboratory evaluation is required when performing a diagnostic evaluation. Vitamin D and calcium supple-mentation should be used to treat nutritional rickets. To prevent rickets and its morbidities, vitamin D prophylaxis in the newborn period is suggested. High dose of vitamin D3, 1.25(OH)2D, and calcium are treatment choices in vitamin D-dependent rickets according to its subgroup. If conventional treatment consisting of phosphate and calcitriol is ineffective in the treatment of phosphopenic rickets, Burosumab is the new treatment option.