Materiały źródłowe

• #1 Epidemiology and etiology of osteomalacia – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-etiology-of-osteomalacia

  Epidemiology and etiology of osteomalacia […] INTRODUCTION […] Osteomalacia is a disorder of decreased or defective mineralization of newly formed osteoid at sites of bone turnover, whereas rickets is a disorder of defective mineralization of cartilage in the epiphyseal growth plates of children. Osteomalacia and rickets can occur together in children (open growth plates), but only osteomalacia occurs in adults (fused growth plates). Several different disorders cause osteomalacia via mechanisms that result in hypocalcemia, hypophosphatemia, or direct inhibition of the mineralization process. […] This topic will review the epidemiology, pathogenesis, and different causes of osteomalacia. The clinical manifestations, diagnosis, and treatment of osteomalacia and the etiology and treatment of rickets are discussed separately.

• #2 Osteomalacia and Rickets

  https://courses.washington.edu/bonephys/hypercalU/opmal2.html

  Osteomalacia means „soft bones”. Osteoid is the bone protein matrix, composed primarily of type 1 collagen. When there is insufficient mineral or osteoblast dysfunction, the osteoid does not mineralize properly, and it accumulates. […] Rickets is a problem near the joints when the bone formed by a growth plate does not mineralize. Then the growth plate becomes thick, wide and irregular. This is seen only in children because adults no longer have growth plates. However, the abnormal joints persist and adults can have deformities such as bowed legs. Most of the hereditary causes of osteomalacia appear during childhood and cause rickets. […] When children do not get enough vitamin D in their diet and also don’t get adequate sunlight exposure to their skin, they develop rickets. […] The following table lists the causes of osteomalacia and the abnormalities found in blood tests (Calcium, phosphate, 25-hydroxy-vitamin D, 1,25-dihydroxy-vitamin D, Parathyroid hormone, alkaline phosphate):

• #3 Rickets – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562285/

  Rickets is a condition characterized by a defect in mineralization of the epiphyseal plates. Rickets could be inherited or acquired. The acquired rickets (nutritional) is the most common cause of rickets worldwide. […] Vitamin D deficiency is, by far, the most common cause of nutritional rickets. Rarely, nutritional deficiency of calcium or phosphorus can result in rickets. Other less frequent causes of rickets include genetic causes, drug-induced rickets, and rickets secondary to liver diseases. […] The main causes of rickets worldwide in older infants and toddlers are due to vitamin D deficiency, either due to nutritional deficiency or due to insufficient sun exposure. […] Genetic causes of rickets may be classified broadly into two types: vitamin D-dependent rickets (calcipenic type), and congenital hypophosphatemic rickets (phosphopenic type).

• #4 Osteomalacia and rickets – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/osteomalacia-and-rickets/

  Osteomalacia and rickets are caused by insufficient calcium, phosphate depletion, and/or direct inhibition of bone mineralization. The most common cause of both disorders is vitamin D deficiency. […] Vitamin D deficiency is the most common cause of both osteomalacia and rickets. Vitamin D-independent causes (i.e., hypophosphatemia, hypocalcemia, medication-induced) and hereditary causes are less common. […] The causes of osteomalacia and rickets involve at least one of the following mechanisms: Calcipenic rickets, Phosphopenic rickets, Direct inhibition of mineralization impaired bone mineralization. […] Low phosphate is present in both calcipenic and phosphopenic forms of osteomalacia and rickets.

• #5 Vitamin D Deficiency including Osteomalacia and Rickets

  https://patient.info/doctor/vitamin-d-deficiency-including-osteomalacia-and-rickets-pro

  Osteomalacia (adults) and rickets (children) are caused by inadequate mineralisation of bone matrix. Vitamin D deficiency causes low calcium and phosphate, which lead to secondary hyperparathyroidism. […] Vitamin D deficiency is most often caused by insufficient exposure to sunlight and nutritional deficiency but can be secondary to a wide range of other underlying causes, such as disorders of the gut, pancreas, liver and kidney. […] Severe dietary calcium deficiency can cause rickets despite adequate vitamin D. […] Genetic causes: Hypophosphataemic rickets: X-linked dominant disorder characterised by growth restriction, inadequate mineralisation of bone, hypophosphataemia and renal defects in phosphate reabsorption and vitamin D metabolism. […] Vitamin D deficiency: individuals with symptomatic osteomalacia or rickets have serum 25-OHD concentrations of less than 25 nmol/L (10 micrograms/L).

• #6

  https://www.nhs.uk/conditions/rickets-and-osteomalacia/

  Rickets is a condition that affects bone development in children. It causes bone pain, poor growth and soft, weak bones that can lead to bone deformities. […] A lack of vitamin D or calcium is the most common cause of rickets. Vitamin D largely comes from exposing the skin to sunlight, but it’s also found in some foods, such as oily fish and eggs. Vitamin D is essential for the formation of strong and healthy bones in children. […] In rare cases, children can be born with a genetic form of rickets. It can also develop if another condition affects how vitamins and minerals are absorbed by the body. […] Any child who doesn’t get enough vitamin D or calcium either through their diet, or from sunlight, can develop rickets. But the condition is more common in children with dark skin, as this means they need more sunlight to get enough vitamin D, as well as children born prematurely or taking medication that interferes with vitamin D.

• #7 Rickets – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rickets/symptoms-causes/syc-20351943

  Rickets is the softening and weakening of bones in children, often because of an extreme and prolonged vitamin D or calcium deficiency. Rare inherited problems also can cause rickets. […] Rickets can occur if your child’s body doesn’t get enough vitamin D or has problems using vitamin D properly. Occasionally, not getting enough calcium or lack of calcium and vitamin D can cause rickets. […] Children who don’t get enough vitamin D from these two sources can develop a deficiency: Sunlight. Your child’s skin produces vitamin D when it’s exposed to sunlight. But children in developed countries tend to spend less time outdoors. They also are more likely to use sunscreen, which blocks the sun’s rays that trigger the skin’s production of vitamin D. […] Some children are born with or develop medical problems that affect the way their bodies absorb vitamin D. Some examples include: Celiac disease. Inflammatory bowel disease. Cystic fibrosis. Kidney problems.

• #8 Rickets and Osteomalacia: Causes and Symptoms

  https://www.massgeneral.org/children/rickets

  Rickets is a disease of growing children that affects how the growth plates of bones develop. Rickets can cause bowing of the legs and bone pain. It can also increase a child’s risk of fracture (broken bone). […] Osteomalacia affects both children and adults and is a disease in which the bones don’t contain enough bone mineral (mostly calcium and phosphate). Like rickets, osteomalacia can cause bone pain and increase the risk of fracture. […] The most common cause of rickets and osteomalacia is vitamin D deficiency (not enough vitamin D). Usually, this is due to: A diet without enough vitamin D. Insufficient vitamin D production in your skin (from having darker colored skin or keeping skin covered without sufficient sun exposure, or living in northern regions of the country). This is particularly a problem during the winter months. Some medical conditions, such as celiac disease, can affect how a child’s gut absorbs vitamin D from food. In a few cases, rickets is the result of rare genetic conditions that affect how the body uses vitamin D or phosphate.

• #9 Osteomalacia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551616/

  Osteomalacia, a metabolic bone disorder commonly known as „soft bone disease,” results from inadequate mineralization of bone tissue due to deficiencies in vitamin D, calcium, or phosphate. This deficiency leads to weakened, softened bones, manifesting in symptoms such as bone pain, muscle weakness, and an increased risk of fractures. […] Understanding osteomalacia is critical, as early recognition and appropriate treatment can prevent the debilitating complications associated with this disorder. […] Osteomalacia is a metabolic bone disease characterized by impaired mineralization of bone matrix. […] Details of the most common and sometimes overlooked causes are as follows: […] Decreased Vitamin D Production […] Cold weather climates reduce skin sunlight exposure and cutaneous synthesis. […] Dark skin and relatively increased melanin compete with 7-dehydrocholesterol ultraviolet-B light absorption. […] Obesity can lead to increased adipose sequestration, which results in less calcidiol substrate available for activation. […] Vitamin D production decreases in older individuals, and the storage of vitamin D declines with age.

• #10 Rickets – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rickets/symptoms-causes/syc-20351943

  Factors that can increase a child’s risk of rickets include: Darker skin pigmentation. Brown or Black skin has more of the pigment melanin, which lowers the skin’s ability to produce vitamin D from sunlight. Mother’s vitamin D deficiency during pregnancy. A baby born to a mother with serious vitamin D deficiency can be born with symptoms of rickets or develop them within a few months after birth. Northern latitudes. Children who live in geographical locations where there is less sunshine are at higher risk of rickets. […] If not treated, rickets can lead to: Failure to grow. Bone deformities. Dental defects. Seizures.

• #11

  https://link.springer.com/article/10.1007/s11914-017-0383-y

  Nutritional rickets and osteomalacia are common in dark-skinned and migrant populations. Their global incidence is rising due to changing population demographics, failing prevention policies and missing implementation strategies. […] The global rickets consensus recognises the equal contribution of vitamin D and dietary calcium in the causation of calcium deprivation and provides a three stage categorisation for sufficiency, insufficiency and deficiency. […] Calcium deprivation is caused by two factors, low dietary calcium and vitamin D intake. Vitamin D deficiency is pandemic in Europe, in winter affecting nearly 18% of the population, but with 371 times higher risk in dark-skinned ethnic minority groups. […] Public health research has identified traditional diets low in calcium, dark skin and cultural full body clothing, as the predominant causes of rickets and osteomalacia in sunny parts of the world such as the Indian subcontinent, the Middle East and Africa.

• #12 Nutritional rickets – a socioeconomic problem | ICCBH2019 | 9th International Conference on Children’s Bone Health | Bone Abstracts

  https://www.bone-abstracts.org/ba/0007/ba0007is6

  Dark skinned people are at greatest risk, and their migration to high latitude countries is testing how well rickets prevention programs are implemented. […] Effective prevention includes provision of calcium-rich food, sunlight exposure and/or vitamin D supplements. […] We have demonstrated that fortification of wheat flour with vitamin D is cost-saving and the optimal strategy to prevent vitamin D deficiency. […] Supplementing the at-risk groups combined with a flour fortification policy offers a more effective and cost-effective option. […] Since the risk groups for rickets and osteomalacia are easily recognizable, supplementation, not testing, should become the new standard.

• #13 Osteomalacia – Causes, Symptoms, Treatment, Diagnosis – MedBroadcast.com

  https://medbroadcast.com/condition/getcondition/osteomalacia

  lack of vitamin D in the diet […] not enough exposure to sunshine this commonly affects people who are confined indoors for prolonged periods of time because of age, disability, or illness (infants in tropical areas are often kept swaddled in clothes and get too little sun) […] having dark skin, which interferes with the effects of sunlight on vitamin D […] certain medications, including some medications prescribed for epilepsy […] very rare tumours. […] Once osteomalacia or rickets has been diagnosed, the doctor must find out why the condition has developed. Although osteomalacia may be caused by a lack of vitamin D in the diet, the cause may be more complex relating not to dietary deficiency of the vitamin but rather a failure to absorb or activate the vitamin.

• #14 Osteomalacia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551616/

  Decreased Vitamin D Absorption […] Nutritional deficiency can cause vitamin D deficiency even with adequate sunlight exposure. […] Malabsorptive syndromes such as Crohn disease, cystic fibrosis, celiac disease, cholestasis, and surgical alteration of the gastrointestinal tract, such as gastric bypass, are associated with deficient absorption of fat-soluble vitamins A, D, E, and K. […] Altered Vitamin D Metabolism […] Chronic kidney disease leads to structural damage, loss of 1-alpha-hydroxylase, and suppressed enzymatic activity secondary to hyperphosphatemia. […] Nephrotic syndrome leads to pathologic excretion of vitamin D-binding protein, which binds to serum calcidiol. […] Liver disease, including cirrhosis and metabolic dysfunction-associated steatotic liver disease, leads to deficient production of calcidiol. […] Pregnancy is associated with decreased calcidiol levels, and the American College of Obstetricians and Gynecologists recommends treating with at least 1000 to 2000 international units daily when vitamin D deficiency is identified.

• #15 Osteomalacia & Rickets – Free Sketchy Medical Lesson

  https://www.sketchy.com/medical-lessons/osteomalacia-rickets

  The mechanisms that influence bone mineralization are essential in understanding bone pathologies like osteomalacia. In osteomalacia and rickets, the underlying mechanism involved decreased mineralization of osteoid, leading to an accumulation of unmineralized collagen matrix while maintaining preserved bone mass. […] Vitamin D deficiency commonly underlies impaired bone mineralization, resulting in calcium and phosphate deficiency. […] Medical conditions like chronic kidney disease, which leads to a deficiency in 1-alpha hydroxylase and impaired vitamin D activation, as well as malabsorption syndromes (e.g. gastric bypass, IBD, chronic pancreatitis) can also compromise vitamin D levels. […] Several factors can contribute to the onset of osteomalacia and rickets. Vitamin D deficiency is a primary etiology and can arise from low dietary intake, malabsorption syndromes (gastric bypass, IBD, chronic pancreatitis), limited UV light exposure, or naturally pigmented skin. Additionally, chronic kidney disease can lead to a deficiency in 1-alpha hydroxylase, affecting vitamin D activation.

• #16 Osteomalacia: Bone disease, causes, symptoms, treatment

  https://www.webmd.com/osteoporosis/what-is-osteomalacia

  The word osteomalacia means soft bones. The condition keeps your bones from mineralizing, or hardening, as they should. That makes them weak and more likely to bend and break. […] Your bones rely on certain minerals to grow strong and stay solid. If your body isnt getting enough of them, you can get osteomalacia. There are different reasons it can happen. The main ones are: […] Youre not taking in enough vitamin D. You need this vitamin to absorb calcium from your diet. […] Your body has a hard time absorbing vitamin D. Gastric bypass or other surgeries that remove part of your stomach or intestines, celiac disease, and certain liver or kidney disorders can all affect your bodys ability to take in vitamin D or convert it to its active form. […] Some seizure medications may cause it. You also can get it if your kidneys arent handling acids correctly. Over time, extra acid in your body fluids can slowly dissolve bone. […] Its rare, but some people have a genetic condition that causes osteomalacia.

• #17 Rickets/Osteomalacia | Select 5-Minute Pediatrics Topics

  https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14093/all/Rickets_Osteomalacia

  Osteomalacia refers to impaired bone mineralization, caused primarily by deficiencies in vitamin D, calcium, and/or phosphate. […] In children, osteomalacia can lead to growth plate abnormalities, termed rickets. […] Rickets arises due to decreased availability of phosphorus and calcium to mineralize the skeletal matrix, leading to growth plate disorganization and accumulation of undermineralized osteoid. This results in growth plate expansion, bone weakening, and skeletal deformities. […] Primary causes include the following: Nutritional: Insufficient vitamin D and/or calcium intakes (common), Insufficient phosphorus intake (rare). […] Deficient sunlight exposure. […] Malabsorption: Celiac disease, Cystic fibrosis, Liver disease. […] Renal tubular defects: Cystinosis, Fanconi syndrome, Renal tubular acidosis. […] Abnormalities in vitamin D metabolism: Anticonvulsant use, Liver disease. […] Genetic forms.

• #18 Osteomalacia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551616/

  Decreased Vitamin D Absorption […] Nutritional deficiency can cause vitamin D deficiency even with adequate sunlight exposure. […] Malabsorptive syndromes such as Crohn disease, cystic fibrosis, celiac disease, cholestasis, and surgical alteration of the gastrointestinal tract, such as gastric bypass, are associated with deficient absorption of fat-soluble vitamins A, D, E, and K. […] Altered Vitamin D Metabolism […] Chronic kidney disease leads to structural damage, loss of 1-alpha-hydroxylase, and suppressed enzymatic activity secondary to hyperphosphatemia. […] Nephrotic syndrome leads to pathologic excretion of vitamin D-binding protein, which binds to serum calcidiol. […] Liver disease, including cirrhosis and metabolic dysfunction-associated steatotic liver disease, leads to deficient production of calcidiol. […] Pregnancy is associated with decreased calcidiol levels, and the American College of Obstetricians and Gynecologists recommends treating with at least 1000 to 2000 international units daily when vitamin D deficiency is identified.

• #19 Osteomalacia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551616/

  Decreased Vitamin D Absorption […] Nutritional deficiency can cause vitamin D deficiency even with adequate sunlight exposure. […] Malabsorptive syndromes such as Crohn disease, cystic fibrosis, celiac disease, cholestasis, and surgical alteration of the gastrointestinal tract, such as gastric bypass, are associated with deficient absorption of fat-soluble vitamins A, D, E, and K. […] Altered Vitamin D Metabolism […] Chronic kidney disease leads to structural damage, loss of 1-alpha-hydroxylase, and suppressed enzymatic activity secondary to hyperphosphatemia. […] Nephrotic syndrome leads to pathologic excretion of vitamin D-binding protein, which binds to serum calcidiol. […] Liver disease, including cirrhosis and metabolic dysfunction-associated steatotic liver disease, leads to deficient production of calcidiol. […] Pregnancy is associated with decreased calcidiol levels, and the American College of Obstetricians and Gynecologists recommends treating with at least 1000 to 2000 international units daily when vitamin D deficiency is identified.

• #20 Osteomalacia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551616/

  Decreased Vitamin D Absorption […] Nutritional deficiency can cause vitamin D deficiency even with adequate sunlight exposure. […] Malabsorptive syndromes such as Crohn disease, cystic fibrosis, celiac disease, cholestasis, and surgical alteration of the gastrointestinal tract, such as gastric bypass, are associated with deficient absorption of fat-soluble vitamins A, D, E, and K. […] Altered Vitamin D Metabolism […] Chronic kidney disease leads to structural damage, loss of 1-alpha-hydroxylase, and suppressed enzymatic activity secondary to hyperphosphatemia. […] Nephrotic syndrome leads to pathologic excretion of vitamin D-binding protein, which binds to serum calcidiol. […] Liver disease, including cirrhosis and metabolic dysfunction-associated steatotic liver disease, leads to deficient production of calcidiol. […] Pregnancy is associated with decreased calcidiol levels, and the American College of Obstetricians and Gynecologists recommends treating with at least 1000 to 2000 international units daily when vitamin D deficiency is identified.

• #21 Osteomalacia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551616/

  Decreased Vitamin D Absorption […] Nutritional deficiency can cause vitamin D deficiency even with adequate sunlight exposure. […] Malabsorptive syndromes such as Crohn disease, cystic fibrosis, celiac disease, cholestasis, and surgical alteration of the gastrointestinal tract, such as gastric bypass, are associated with deficient absorption of fat-soluble vitamins A, D, E, and K. […] Altered Vitamin D Metabolism […] Chronic kidney disease leads to structural damage, loss of 1-alpha-hydroxylase, and suppressed enzymatic activity secondary to hyperphosphatemia. […] Nephrotic syndrome leads to pathologic excretion of vitamin D-binding protein, which binds to serum calcidiol. […] Liver disease, including cirrhosis and metabolic dysfunction-associated steatotic liver disease, leads to deficient production of calcidiol. […] Pregnancy is associated with decreased calcidiol levels, and the American College of Obstetricians and Gynecologists recommends treating with at least 1000 to 2000 international units daily when vitamin D deficiency is identified.

• #22 Osteomalacia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551616/

  Decreased Vitamin D Absorption […] Nutritional deficiency can cause vitamin D deficiency even with adequate sunlight exposure. […] Malabsorptive syndromes such as Crohn disease, cystic fibrosis, celiac disease, cholestasis, and surgical alteration of the gastrointestinal tract, such as gastric bypass, are associated with deficient absorption of fat-soluble vitamins A, D, E, and K. […] Altered Vitamin D Metabolism […] Chronic kidney disease leads to structural damage, loss of 1-alpha-hydroxylase, and suppressed enzymatic activity secondary to hyperphosphatemia. […] Nephrotic syndrome leads to pathologic excretion of vitamin D-binding protein, which binds to serum calcidiol. […] Liver disease, including cirrhosis and metabolic dysfunction-associated steatotic liver disease, leads to deficient production of calcidiol. […] Pregnancy is associated with decreased calcidiol levels, and the American College of Obstetricians and Gynecologists recommends treating with at least 1000 to 2000 international units daily when vitamin D deficiency is identified.

• #23 Overview of rickets in children – UpToDate

  https://www.uptodate.com/contents/overview-of-rickets-in-children

  Normal bone growth and mineralization require adequate calcium and phosphate, the two major nutritional elements that constitute the crystalline component of bone. Deficient mineralization can result in rickets and/or osteomalacia. Rickets refers to deficient mineralization at the growth plate, as well as architectural disruption of this structure. Osteomalacia refers to impaired mineralization of the bone matrix. Rickets and osteomalacia usually occur together as long as the growth plates are open; only osteomalacia occurs after the growth plates have fused. […] The etiology and treatment of calcipenic and phosphopenic rickets are discussed separately. […] Calcipenic rickets is caused by calcium deficiency, which usually is due to insufficient intake of vitamin D or failure to metabolize dietary vitamin D into its active form. In some cases, it is caused by insufficient intake or absorption of calcium in the setting of normal vitamin D levels. Calcipenic rickets may be associated with low serum calcium levels but also occurs in the setting of normocalcemia. […] Phosphopenic rickets is characterized by low serum levels of phosphorus, usually caused by renal phosphate wasting and, less commonly, by nutritional phosphorus deficiency.

• #24 Vitamin D Deficiency including Osteomalacia and Rickets

  https://patient.info/doctor/vitamin-d-deficiency-including-osteomalacia-and-rickets-pro

  Osteomalacia (adults) and rickets (children) are caused by inadequate mineralisation of bone matrix. Vitamin D deficiency causes low calcium and phosphate, which lead to secondary hyperparathyroidism. […] Vitamin D deficiency is most often caused by insufficient exposure to sunlight and nutritional deficiency but can be secondary to a wide range of other underlying causes, such as disorders of the gut, pancreas, liver and kidney. […] Severe dietary calcium deficiency can cause rickets despite adequate vitamin D. […] Genetic causes: Hypophosphataemic rickets: X-linked dominant disorder characterised by growth restriction, inadequate mineralisation of bone, hypophosphataemia and renal defects in phosphate reabsorption and vitamin D metabolism. […] Vitamin D deficiency: individuals with symptomatic osteomalacia or rickets have serum 25-OHD concentrations of less than 25 nmol/L (10 micrograms/L).

• #25 Rickets | Endocrine Conditions

  https://www.yourhormones.info/endocrine-conditions/rickets/

  Rickets is a condition in children where there is abnormal softening of the bones due to the lack of key minerals. It is also known as osteomalacia in adults. […] The commonest cause of rickets/osteomalacia is lack of vitamin D over a long period of time. […] A smaller amount of vitamin D comes from diet. […] Vitamin D deficiency can also result from the body not absorbing nutrients properly (malabsorption) due to conditions such as coeliac disease, stomach and abdominal surgery, Crohns disease and chronic. […] People with chronic kidney disease or liver disease such as cirrhosis, are also at risk of vitamin D deficiency. […] Babies depend on their mothers to provide them with adequate vitamin D. A lack of vitamin D in pregnant or breastfeeding women can lead to rickets in the child. […] Less commonly, osteomalacia/rickets can be caused by phosphate or calcium deficiency. […] Severe dietary calcium deficiency can cause rickets/osteomalacia, although it is rarely seen in the UK.

• #26 Rickets and Osteomalacia Causes: Why Do These Diseases Occur?

  https://ce4rt.com/rad-tech-talk/rickets-and-osteomalacia-causes/?srsltid=AfmBOorARBjAjaJttEKaJICwDkyZB26IVTJ4mV8nOm1N5qF88ZQAk-4D

  Deficiency of vitamin D is a common cause of rickets and osteomalacia. […] Sunlight exposure is important to prevent vitamin D deficiency. […] In addition to vitamin D deficiency, rickets and osteomalacia causes include a deficiency of phosphate in the body. A form of the disease called hypophosphatemic rickets is genetic and is inherited as an X-linked disorder. More commonly, however, the phosphate deficiency that leads to rickets and osteomalacia is the result of non-genetic factors. The kidneys in some individuals have a reduced ability to retain phosphate, putting them at risk of phosphate deficiency. Diseases which damage the renal tubules can lead to this condition as this is the site where phosphate is reabsorbed by the kidneys. […] In addition, diet can play a role in the development of phosphate deficiency. People who consume large amounts of aluminum hydroxide in antacids may suffer from phosphate deficiency due to the absorption of dietary phosphate being prevented by these drugs. Certain drugs are known to interfere with bone mineralization or phosphate absorption. Rickets can develop as a result of inherited or acquired defects in the kidney tubule that affect acid secretion. Finally, some tumors secrete substances that promote the loss of phosphate from the body, leading to what is known as oncogenic or tumor-induced osteomalacia. These are relatively rare rickets and osteomalacia causes.

• #27 Rickets and Osteomalacia Causes: Why Do These Diseases Occur?

  https://ce4rt.com/rad-tech-talk/rickets-and-osteomalacia-causes/?srsltid=AfmBOorARBjAjaJttEKaJICwDkyZB26IVTJ4mV8nOm1N5qF88ZQAk-4D

  Deficiency of vitamin D is a common cause of rickets and osteomalacia. […] Sunlight exposure is important to prevent vitamin D deficiency. […] In addition to vitamin D deficiency, rickets and osteomalacia causes include a deficiency of phosphate in the body. A form of the disease called hypophosphatemic rickets is genetic and is inherited as an X-linked disorder. More commonly, however, the phosphate deficiency that leads to rickets and osteomalacia is the result of non-genetic factors. The kidneys in some individuals have a reduced ability to retain phosphate, putting them at risk of phosphate deficiency. Diseases which damage the renal tubules can lead to this condition as this is the site where phosphate is reabsorbed by the kidneys. […] In addition, diet can play a role in the development of phosphate deficiency. People who consume large amounts of aluminum hydroxide in antacids may suffer from phosphate deficiency due to the absorption of dietary phosphate being prevented by these drugs. Certain drugs are known to interfere with bone mineralization or phosphate absorption. Rickets can develop as a result of inherited or acquired defects in the kidney tubule that affect acid secretion. Finally, some tumors secrete substances that promote the loss of phosphate from the body, leading to what is known as oncogenic or tumor-induced osteomalacia. These are relatively rare rickets and osteomalacia causes.

• #28

  https://www.nhs.uk/conditions/rickets-and-osteomalacia/causes/

  Rickets usually occurs because of a lack of vitamin D or calcium, although it can also be caused by a genetic defect or another health condition. […] The most common cause of rickets is a lack of vitamin D or calcium in a child’s diet. […] Over time, a vitamin D or calcium deficiency will cause rickets in children and soft bones (osteomalacia) in adults. […] Rare forms of rickets can also occur in some inherited (genetic) disorders. […] Occasionally, rickets develops in children with rare forms of kidney, liver and intestinal conditions.

• #29 Rickets: Definition, Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22459-rickets

  Rickets is typically caused by a lack of vitamin D, but in rare cases, is caused by an underlying genetic disorder. […] Rickets is different from osteomalacia, which is a similar condition seen in adults. […] Nutrition problems or genetics are usually the cause of rickets. […] Nutritional rickets: This is usually caused by not taking in enough vitamin D, which your body uses to absorb calcium. […] Inherited rickets: Several genetic diseases interfere with how your child’s body absorbs vitamin D. Other genetic conditions affect how your body handles phosphorus and also cause rickets. These types of disorders are rare.

• #30 Rickets – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562285/

  Rickets is a condition characterized by a defect in mineralization of the epiphyseal plates. Rickets could be inherited or acquired. The acquired rickets (nutritional) is the most common cause of rickets worldwide. […] Vitamin D deficiency is, by far, the most common cause of nutritional rickets. Rarely, nutritional deficiency of calcium or phosphorus can result in rickets. Other less frequent causes of rickets include genetic causes, drug-induced rickets, and rickets secondary to liver diseases. […] The main causes of rickets worldwide in older infants and toddlers are due to vitamin D deficiency, either due to nutritional deficiency or due to insufficient sun exposure. […] Genetic causes of rickets may be classified broadly into two types: vitamin D-dependent rickets (calcipenic type), and congenital hypophosphatemic rickets (phosphopenic type).

• #31 Rickets – Pediatric Bone Health Program – Endocrinology – Golisano Children’s Hospital – University of Rochester Medical Center

  https://www.urmc.rochester.edu/childrens-hospital/endocrinology/pediatric-bone-health-program/conditions-we-treat/rickets

  Kidney disease. Some children are born with or develop kidneys that dont work well. If they kidneys are damaged, too much calcium and phosphorus can be lost in the urine. […] Malabsorption. Some children who have severe gastrointestinal or liver disease have trouble absorbing enough vitamin D, calcium, and phosphorus from their diet. […] Tumors. There are rare types of tumors that can cause the kidney to lose too much phosphorus into the urine. This condition is known as tumor-induced osteomalacia. […] Some children can develop rickets as a result of a genetic condition present at birth. Names of these conditions include: X-linked hypophosphatemic rickets (XLH), Hereditary hypophosphatemic rickets with hypercalciuria, Vitamin D-dependent rickets type I (also known as 1-alpha-hydroxylase deficiency), Vitamin D-dependent rickets type II (also known as vitamin D resistance).

• #32

  https://www.orthobullets.com/basic-science/9031/rickets

  Rickets is a metabolic bone disease caused by a defect in mineralization of osteoid matrix caused by inadequate calcium and phosphate that occurs prior to closure of the physes. […] Treatment involves medical management to resolve the underlying etiology of rickets. […] Vitamin D and PTH play an important role in calcium homeostasis. […] Disruption of calcium/phosphate homeostasis leads to poor calcification of cartilage matrix of growing long bones. […] Rickets is known as osteomalacia if it occurs after physeal closure. […] It can be congenital or acquired. […] Vitamin D-resistant (familial hypophosphatemic) is the most common form of heritable rickets caused by inability of renal tubules to absorb phosphate. […] Vitamin D-deficient (nutritional) results from decreased dietary intake of Vitamin D. […] Low Vitamin D levels lead to decreased intestinal absorption of calcium. […] Vitamin D-dependent (type I type II) is a rare disorder that leads to clinical features similar to Vitamin D-deficient rickets but more severe.

• #33 Rickets – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562285/

  Rickets is a condition characterized by a defect in mineralization of the epiphyseal plates. Rickets could be inherited or acquired. The acquired rickets (nutritional) is the most common cause of rickets worldwide. […] Vitamin D deficiency is, by far, the most common cause of nutritional rickets. Rarely, nutritional deficiency of calcium or phosphorus can result in rickets. Other less frequent causes of rickets include genetic causes, drug-induced rickets, and rickets secondary to liver diseases. […] The main causes of rickets worldwide in older infants and toddlers are due to vitamin D deficiency, either due to nutritional deficiency or due to insufficient sun exposure. […] Genetic causes of rickets may be classified broadly into two types: vitamin D-dependent rickets (calcipenic type), and congenital hypophosphatemic rickets (phosphopenic type).

• #34 Osteomalacia in Adults: A Practical Insight for Clinicians

  https://www.mdpi.com/2077-0383/12/7/2714

  In a practical way, we can divide the causes of OM and rickets based on the serum levels of calcium and phosphate. In this way, we can distinguish the calcipenic and phosphopenic forms. […] Among the rare causes of OM, hereditary VD deficiencies debut at the pediatric age, being very unlikely to reach adulthood without being diagnosed. […] Among the OM, in which the main determinant factor is phosphate deficiency, it is exceptional that the cause is nutritional since habitual diets contain enough phosphorus. […] XLH is caused by mutations in a gene on the X chromosome (Xp22.11), which encodes a cell surface protease called PHEX (phosphate-regulating neutral endopeptidase). […] Oncogenic OM, also known as tumor-induced OM (TIO), is a rare paraneoplastic syndrome associated with renal phosphate wasting in response to FGF23 secretion by a tumor. […] Several drugs can cause OM, generally secondary to hypophosphatemia. Among them, we can include diuretics, corticosteroids, and carbonic anhydrase inhibitors, all due to their phosphaturic effect.

• #35 Epidemiology and etiology of osteomalacia – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-etiology-of-osteomalacia

  EPIDEMIOLOGY […] There is a growing prevalence of vitamin D deficiency in many countries. Severe and prolonged vitamin D deficiency (25-hydroxyvitamin D <10 ng/mL [25 nmol/L]) can result in hypocalcemia, secondary hyperparathyroidism, secondary hypophosphatemia, and osteomalacia. Nutritional vitamin D deficiency is therefore an increasingly common cause of osteomalacia in adults. Populations at risk include homebound older adults who have little sun exposure and insufficient dietary calcium and vitamin D, patients with malabsorption (eg, related to gastrointestinal bypass surgery, inflammatory bowel disease, or celiac disease), and those with limited sun exposure due to clothing that covers most of the body or restrictions related to skin conditions. [...] Hereditary forms of vitamin D deficiency and resistance, which are identified in childhood, are also associated with osteomalacia in adults, but these disorders are less common. Osteomalacia can also occur in patients with primary hypophosphatemia due to one of the hereditary hypophosphatemic rickets syndromes (eg, X-linked hypophosphatemic rickets, autosomal dominant hypophosphatemic rickets); these rare syndromes usually present in childhood but persist in adulthood. Hypophosphatemic osteomalacia presenting in adulthood may also be due to tumor-induced osteomalacia, an acquired paraneoplastic syndrome of renal phosphate wasting. Drug-induced Fanconi syndrome can also result in renal phosphate wasting and osteomalacia.

• #36 Rickets – Pediatric Bone Health Program – Endocrinology – Golisano Children’s Hospital – University of Rochester Medical Center

  https://www.urmc.rochester.edu/childrens-hospital/endocrinology/pediatric-bone-health-program/conditions-we-treat/rickets

  Kidney disease. Some children are born with or develop kidneys that dont work well. If they kidneys are damaged, too much calcium and phosphorus can be lost in the urine. […] Malabsorption. Some children who have severe gastrointestinal or liver disease have trouble absorbing enough vitamin D, calcium, and phosphorus from their diet. […] Tumors. There are rare types of tumors that can cause the kidney to lose too much phosphorus into the urine. This condition is known as tumor-induced osteomalacia. […] Some children can develop rickets as a result of a genetic condition present at birth. Names of these conditions include: X-linked hypophosphatemic rickets (XLH), Hereditary hypophosphatemic rickets with hypercalciuria, Vitamin D-dependent rickets type I (also known as 1-alpha-hydroxylase deficiency), Vitamin D-dependent rickets type II (also known as vitamin D resistance).

• #37 Osteomalacia and Rickets

  https://courses.washington.edu/bonephys/hypercalU/opmal2.html

  This really depends on the cause of the osteomalacia. Treatment can be as simple as vitamin D or as complex as parenteral nutrition. […] Hypophosphatasia has a totally different pathophysiology from the other kinds of osteomalaica. It is caused by deficiency in the enzyme alkaline phosphatase. […] Vitamin D deficiency is the most common form of osteomalacia, and is usually due to a combination of low dietary vitamin D plus lack of exposure to sunlight. […] More about oncogenic osteomalacia. […] A Klotho mutation has been described, leading to osteomalacia.

• #38 Osteomalacia and Rickets

  https://courses.washington.edu/bonephys/hypercalU/opmal2.html

  This really depends on the cause of the osteomalacia. Treatment can be as simple as vitamin D or as complex as parenteral nutrition. […] Hypophosphatasia has a totally different pathophysiology from the other kinds of osteomalaica. It is caused by deficiency in the enzyme alkaline phosphatase. […] Vitamin D deficiency is the most common form of osteomalacia, and is usually due to a combination of low dietary vitamin D plus lack of exposure to sunlight. […] More about oncogenic osteomalacia. […] A Klotho mutation has been described, leading to osteomalacia.

• #39 Osteomalacia and Rickets

  https://courses.washington.edu/bonephys/hypercalU/opmal2.html

  This really depends on the cause of the osteomalacia. Treatment can be as simple as vitamin D or as complex as parenteral nutrition. […] Hypophosphatasia has a totally different pathophysiology from the other kinds of osteomalaica. It is caused by deficiency in the enzyme alkaline phosphatase. […] Vitamin D deficiency is the most common form of osteomalacia, and is usually due to a combination of low dietary vitamin D plus lack of exposure to sunlight. […] More about oncogenic osteomalacia. […] A Klotho mutation has been described, leading to osteomalacia.

• #40 Loss of DMP1 causes rickets and osteomalacia and identifies a role for osteocytes in mineral metabolism | Nature Genetics

  https://www.nature.com/articles/ng1905

  The osteocyte, a terminally differentiated cell comprising 90%-95% of all bone cells, may have multiple functions, including acting as a mechanosensor in bone (re)modeling. Dentin matrix protein 1 (encoded by DMP1) is highly expressed in osteocytes and, when deleted in mice, results in a hypomineralized bone phenotype. […] Both Dmp1-null mice and individuals with a newly identified disorder, autosomal recessive hypophosphatemic rickets, manifest rickets and osteomalacia with isolated renal phosphate-wasting associated with elevated fibroblast growth factor 23 (FGF23) levels and normocalciuria. […] Mechanistic studies using Dmp1-null mice demonstrated that absence of DMP1 results in defective osteocyte maturation and increased FGF23 expression, leading to pathological changes in bone mineralization. Our findings suggest a bone-renal axis that is central to guiding proper mineral metabolism.

• #41

  https://111.wales.nhs.uk/encyclopaedia/y/article/yllechau

  The most common cause of rickets is a lack of vitamin D or calcium in a child’s diet. Both are essential for children to develop strong and healthy bones. […] Rare forms of rickets can also occur in some inherited (genetic) disorders. […] Occasionally, rickets develops in children with rare forms of kidney, liver and intestinal conditions. These can affect the absorption of vitamins and minerals. […] As most cases of rickets are caused by a vitamin D and calcium deficiency, it is usually treated by increasing a person’s intake of vitamin D and calcium. […] If you have osteomalacia the adult form of rickets that causes soft bones treatment with supplements will usually cure the condition.

• #42 Rickets: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/985510-overview

  In the vitamin D deficiency state, hypocalcemia develops, which stimulates excess secretion of parathyroid hormone. In turn, renal phosphorus loss is enhanced, further reducing deposition of calcium in the bone. […] Intestinal malabsorption of fat and diseases of the liver or kidney may produce the clinical and secondary biochemical picture of nutritional rickets. […] Studies have noted that disorders of increased fibroblast growth factor 23 (FGF-23) function are associated with rickets.

• #43 Osteomalacia – Zero To Finals

  https://zerotofinals.com/medicine/rheumatology/osteomalacia/

  Osteomalacia is a condition where defective bone mineralisation causes “soft” bones. It results from insufficient vitamin D. The same process in children causes rickets. […] Patients with malabsorption disorders (e.g., inflammatory bowel disease) are at higher risk of vitamin D deficiency. Patients with chronic kidney disease are also at higher risk of vitamin D deficiency as the kidneys help convert vitamin D into its active form. […] Inadequate vitamin D leads to low serum calcium and phosphate. Since calcium and phosphate are required for the construction of bone, low levels result in defective bone mineralisation and osteomalacia. […] Low calcium leads to increased parathyroid hormone (PTH) secretion by the parathyroid glands (secondary hyperparathyroidism). Increased parathyroid hormone promotes calcium reabsorption from the bones, further impairing bone mineralisation.

• #44 Osteomalacia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551616/

  Hypophosphatemia or Hypocalcemia […] Renal tubular acidosis, such as in Fanconi syndrome, alters ion absorption and excretion. […] Multiple intravenous iron infusions have been found to cause hypophosphatemia and osteomalacia. […] Tumor-induced osteomalacia, also known as oncogenic osteomalacia, is a rare acquired paraneoplastic disease characterized by hypophosphatemia, elevated or inappropriately normal levels of fibroblast growth factor 23, and renal phosphate wasting. […] Tumor-induced osteomalacia is commonly caused by benign tumors involving the skin, muscles, bones of the extremities, or the paranasal sinuses. […] Medications […] Antiepileptic drugs, including phenobarbital, phenytoin, and carbamazepine, enhance the catabolism of calcidiol via induction of cytochrome P450 activity. […] Isoniazid, rifampicin, and theophylline may also precipitate vitamin D deficiency in the same manner as antiepileptic medications. […] Antifungal agents such as ketoconazole increase vitamin D requirements by inhibiting 1-alpha-hydroxylase. […] Long-term corticosteroid use also has implications for vitamin D deficiency, possibly by increasing 24-hydroxylase activity.

• #45 Osteomalacia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551616/

  Hypophosphatemia or Hypocalcemia […] Renal tubular acidosis, such as in Fanconi syndrome, alters ion absorption and excretion. […] Multiple intravenous iron infusions have been found to cause hypophosphatemia and osteomalacia. […] Tumor-induced osteomalacia, also known as oncogenic osteomalacia, is a rare acquired paraneoplastic disease characterized by hypophosphatemia, elevated or inappropriately normal levels of fibroblast growth factor 23, and renal phosphate wasting. […] Tumor-induced osteomalacia is commonly caused by benign tumors involving the skin, muscles, bones of the extremities, or the paranasal sinuses. […] Medications […] Antiepileptic drugs, including phenobarbital, phenytoin, and carbamazepine, enhance the catabolism of calcidiol via induction of cytochrome P450 activity. […] Isoniazid, rifampicin, and theophylline may also precipitate vitamin D deficiency in the same manner as antiepileptic medications. […] Antifungal agents such as ketoconazole increase vitamin D requirements by inhibiting 1-alpha-hydroxylase. […] Long-term corticosteroid use also has implications for vitamin D deficiency, possibly by increasing 24-hydroxylase activity.

• #46 Rickets Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/rickets

  Rickets is a disorder that occurs in children before bone growth is complete. It is caused by a lack of vitamin D, calcium, or phosphate. It leads to softening and weakening of the bones. […] Vitamin D helps the body control calcium and phosphate levels. If the blood levels of these minerals become too low, the body may produce hormones that cause calcium and phosphate to be released from the bones. This leads to weak and soft bones. […] Lack of vitamin D production by the skin may occur in people who: Live in climates with little exposure to sunlight, Must stay indoors, Work indoors during the daylight hours. […] Not getting enough calcium and phosphorous in your diet can also lead to rickets. Rickets caused by a lack of these minerals in the diet is rare in developed countries. […] Your genes may increase your risk for rickets. Hereditary rickets is a form of the disease that is passed down through families. It occurs when the kidneys are unable to hold onto the mineral phosphate. Rickets may also be caused by kidney disorders that involve renal tubular acidosis. […] Sometimes, rickets may occur in children who have disorders of the liver. These children cannot convert vitamin D to its active form.

• #47 Osteomalacia: Causes, symptoms, diagnosis, treatment, and more

  https://www.medicalnewstoday.com/articles/osteomalacia

  Along with underlying conditions, additional factors that can make it difficult for people to absorb vitamin D include: diets that are low in calcium; surgeries to promote weight loss; some medications, such as antacids, and some older antiepileptic drugs, such as topiramate; lactose intolerance, as a person will not get vitamin D from fortified milk; cirrhosis.

• #48 Rickets and Osteomalacia | Radiology Key

  https://radiologykey.com/rickets-and-osteomalacia/

  Vitamin D deficiency is mostly the combined consequence of low dietary intake (or malabsorption) and decreased biosynthesis of vitamin D in the skin following deficient sun exposure. Disorders of the pancreas and hepatobiliary system, as well as small-intestine malabsorptive states such as celiac disease, regional enteritis, and bypass surgery can result in vitamin D malabsorption and deficiency. […] Abnormalities in the hydroxylation of provitamin D3 in liver and kidney can also lead to osteomalacia and rickets. While dysfunction of 25-hydroxylase following severe liver disease or isoniazide treatment is an infrequent cause of vitamin D deficiency, impaired 1-hydroxylase is common in patients with advanced renal disease. […] The resultant hypocalcemia following low vitamin D and phosphate retention in chronic renal failure results in secondary hyperparathyroidism, which increases calcium and phosphate release from the skeleton leading to osteomalacia and osteopenia.

• #49 Rickets and Osteomalacia | Radiology Key

  https://radiologykey.com/rickets-and-osteomalacia/

  Vitamin D deficiency is mostly the combined consequence of low dietary intake (or malabsorption) and decreased biosynthesis of vitamin D in the skin following deficient sun exposure. Disorders of the pancreas and hepatobiliary system, as well as small-intestine malabsorptive states such as celiac disease, regional enteritis, and bypass surgery can result in vitamin D malabsorption and deficiency. […] Abnormalities in the hydroxylation of provitamin D3 in liver and kidney can also lead to osteomalacia and rickets. While dysfunction of 25-hydroxylase following severe liver disease or isoniazide treatment is an infrequent cause of vitamin D deficiency, impaired 1-hydroxylase is common in patients with advanced renal disease. […] The resultant hypocalcemia following low vitamin D and phosphate retention in chronic renal failure results in secondary hyperparathyroidism, which increases calcium and phosphate release from the skeleton leading to osteomalacia and osteopenia.

• #50 Osteomalacia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551616/

  Hypophosphatemia or Hypocalcemia […] Renal tubular acidosis, such as in Fanconi syndrome, alters ion absorption and excretion. […] Multiple intravenous iron infusions have been found to cause hypophosphatemia and osteomalacia. […] Tumor-induced osteomalacia, also known as oncogenic osteomalacia, is a rare acquired paraneoplastic disease characterized by hypophosphatemia, elevated or inappropriately normal levels of fibroblast growth factor 23, and renal phosphate wasting. […] Tumor-induced osteomalacia is commonly caused by benign tumors involving the skin, muscles, bones of the extremities, or the paranasal sinuses. […] Medications […] Antiepileptic drugs, including phenobarbital, phenytoin, and carbamazepine, enhance the catabolism of calcidiol via induction of cytochrome P450 activity. […] Isoniazid, rifampicin, and theophylline may also precipitate vitamin D deficiency in the same manner as antiepileptic medications. […] Antifungal agents such as ketoconazole increase vitamin D requirements by inhibiting 1-alpha-hydroxylase. […] Long-term corticosteroid use also has implications for vitamin D deficiency, possibly by increasing 24-hydroxylase activity.

• #51 Osteomalacia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551616/

  Hypophosphatemia or Hypocalcemia […] Renal tubular acidosis, such as in Fanconi syndrome, alters ion absorption and excretion. […] Multiple intravenous iron infusions have been found to cause hypophosphatemia and osteomalacia. […] Tumor-induced osteomalacia, also known as oncogenic osteomalacia, is a rare acquired paraneoplastic disease characterized by hypophosphatemia, elevated or inappropriately normal levels of fibroblast growth factor 23, and renal phosphate wasting. […] Tumor-induced osteomalacia is commonly caused by benign tumors involving the skin, muscles, bones of the extremities, or the paranasal sinuses. […] Medications […] Antiepileptic drugs, including phenobarbital, phenytoin, and carbamazepine, enhance the catabolism of calcidiol via induction of cytochrome P450 activity. […] Isoniazid, rifampicin, and theophylline may also precipitate vitamin D deficiency in the same manner as antiepileptic medications. […] Antifungal agents such as ketoconazole increase vitamin D requirements by inhibiting 1-alpha-hydroxylase. […] Long-term corticosteroid use also has implications for vitamin D deficiency, possibly by increasing 24-hydroxylase activity.

• #52 Osteomalacia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551616/

  Hypophosphatemia or Hypocalcemia […] Renal tubular acidosis, such as in Fanconi syndrome, alters ion absorption and excretion. […] Multiple intravenous iron infusions have been found to cause hypophosphatemia and osteomalacia. […] Tumor-induced osteomalacia, also known as oncogenic osteomalacia, is a rare acquired paraneoplastic disease characterized by hypophosphatemia, elevated or inappropriately normal levels of fibroblast growth factor 23, and renal phosphate wasting. […] Tumor-induced osteomalacia is commonly caused by benign tumors involving the skin, muscles, bones of the extremities, or the paranasal sinuses. […] Medications […] Antiepileptic drugs, including phenobarbital, phenytoin, and carbamazepine, enhance the catabolism of calcidiol via induction of cytochrome P450 activity. […] Isoniazid, rifampicin, and theophylline may also precipitate vitamin D deficiency in the same manner as antiepileptic medications. […] Antifungal agents such as ketoconazole increase vitamin D requirements by inhibiting 1-alpha-hydroxylase. […] Long-term corticosteroid use also has implications for vitamin D deficiency, possibly by increasing 24-hydroxylase activity.

• #53 Rickets and Osteomalacia Causes: Why Do These Diseases Occur?

  https://ce4rt.com/rad-tech-talk/rickets-and-osteomalacia-causes/?srsltid=AfmBOorARBjAjaJttEKaJICwDkyZB26IVTJ4mV8nOm1N5qF88ZQAk-4D

  Deficiency of vitamin D is a common cause of rickets and osteomalacia. […] Sunlight exposure is important to prevent vitamin D deficiency. […] In addition to vitamin D deficiency, rickets and osteomalacia causes include a deficiency of phosphate in the body. A form of the disease called hypophosphatemic rickets is genetic and is inherited as an X-linked disorder. More commonly, however, the phosphate deficiency that leads to rickets and osteomalacia is the result of non-genetic factors. The kidneys in some individuals have a reduced ability to retain phosphate, putting them at risk of phosphate deficiency. Diseases which damage the renal tubules can lead to this condition as this is the site where phosphate is reabsorbed by the kidneys. […] In addition, diet can play a role in the development of phosphate deficiency. People who consume large amounts of aluminum hydroxide in antacids may suffer from phosphate deficiency due to the absorption of dietary phosphate being prevented by these drugs. Certain drugs are known to interfere with bone mineralization or phosphate absorption. Rickets can develop as a result of inherited or acquired defects in the kidney tubule that affect acid secretion. Finally, some tumors secrete substances that promote the loss of phosphate from the body, leading to what is known as oncogenic or tumor-induced osteomalacia. These are relatively rare rickets and osteomalacia causes.

• #54 Osteomalacia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551616/

  Hypophosphatemia or Hypocalcemia […] Renal tubular acidosis, such as in Fanconi syndrome, alters ion absorption and excretion. […] Multiple intravenous iron infusions have been found to cause hypophosphatemia and osteomalacia. […] Tumor-induced osteomalacia, also known as oncogenic osteomalacia, is a rare acquired paraneoplastic disease characterized by hypophosphatemia, elevated or inappropriately normal levels of fibroblast growth factor 23, and renal phosphate wasting. […] Tumor-induced osteomalacia is commonly caused by benign tumors involving the skin, muscles, bones of the extremities, or the paranasal sinuses. […] Medications […] Antiepileptic drugs, including phenobarbital, phenytoin, and carbamazepine, enhance the catabolism of calcidiol via induction of cytochrome P450 activity. […] Isoniazid, rifampicin, and theophylline may also precipitate vitamin D deficiency in the same manner as antiepileptic medications. […] Antifungal agents such as ketoconazole increase vitamin D requirements by inhibiting 1-alpha-hydroxylase. […] Long-term corticosteroid use also has implications for vitamin D deficiency, possibly by increasing 24-hydroxylase activity.

• #55 Osteomalacia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551616/

  Hypophosphatemia or Hypocalcemia […] Renal tubular acidosis, such as in Fanconi syndrome, alters ion absorption and excretion. […] Multiple intravenous iron infusions have been found to cause hypophosphatemia and osteomalacia. […] Tumor-induced osteomalacia, also known as oncogenic osteomalacia, is a rare acquired paraneoplastic disease characterized by hypophosphatemia, elevated or inappropriately normal levels of fibroblast growth factor 23, and renal phosphate wasting. […] Tumor-induced osteomalacia is commonly caused by benign tumors involving the skin, muscles, bones of the extremities, or the paranasal sinuses. […] Medications […] Antiepileptic drugs, including phenobarbital, phenytoin, and carbamazepine, enhance the catabolism of calcidiol via induction of cytochrome P450 activity. […] Isoniazid, rifampicin, and theophylline may also precipitate vitamin D deficiency in the same manner as antiepileptic medications. […] Antifungal agents such as ketoconazole increase vitamin D requirements by inhibiting 1-alpha-hydroxylase. […] Long-term corticosteroid use also has implications for vitamin D deficiency, possibly by increasing 24-hydroxylase activity.

• #56 Osteomalacia: Causes, symptoms, diagnosis, treatment, and more

  https://www.medicalnewstoday.com/articles/osteomalacia

  Along with underlying conditions, additional factors that can make it difficult for people to absorb vitamin D include: diets that are low in calcium; surgeries to promote weight loss; some medications, such as antacids, and some older antiepileptic drugs, such as topiramate; lactose intolerance, as a person will not get vitamin D from fortified milk; cirrhosis.

• #57 Osteomalacia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551616/

  Hypophosphatemia or Hypocalcemia […] Renal tubular acidosis, such as in Fanconi syndrome, alters ion absorption and excretion. […] Multiple intravenous iron infusions have been found to cause hypophosphatemia and osteomalacia. […] Tumor-induced osteomalacia, also known as oncogenic osteomalacia, is a rare acquired paraneoplastic disease characterized by hypophosphatemia, elevated or inappropriately normal levels of fibroblast growth factor 23, and renal phosphate wasting. […] Tumor-induced osteomalacia is commonly caused by benign tumors involving the skin, muscles, bones of the extremities, or the paranasal sinuses. […] Medications […] Antiepileptic drugs, including phenobarbital, phenytoin, and carbamazepine, enhance the catabolism of calcidiol via induction of cytochrome P450 activity. […] Isoniazid, rifampicin, and theophylline may also precipitate vitamin D deficiency in the same manner as antiepileptic medications. […] Antifungal agents such as ketoconazole increase vitamin D requirements by inhibiting 1-alpha-hydroxylase. […] Long-term corticosteroid use also has implications for vitamin D deficiency, possibly by increasing 24-hydroxylase activity.

• #58 Osteomalacia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551616/

  Hypophosphatemia or Hypocalcemia […] Renal tubular acidosis, such as in Fanconi syndrome, alters ion absorption and excretion. […] Multiple intravenous iron infusions have been found to cause hypophosphatemia and osteomalacia. […] Tumor-induced osteomalacia, also known as oncogenic osteomalacia, is a rare acquired paraneoplastic disease characterized by hypophosphatemia, elevated or inappropriately normal levels of fibroblast growth factor 23, and renal phosphate wasting. […] Tumor-induced osteomalacia is commonly caused by benign tumors involving the skin, muscles, bones of the extremities, or the paranasal sinuses. […] Medications […] Antiepileptic drugs, including phenobarbital, phenytoin, and carbamazepine, enhance the catabolism of calcidiol via induction of cytochrome P450 activity. […] Isoniazid, rifampicin, and theophylline may also precipitate vitamin D deficiency in the same manner as antiepileptic medications. […] Antifungal agents such as ketoconazole increase vitamin D requirements by inhibiting 1-alpha-hydroxylase. […] Long-term corticosteroid use also has implications for vitamin D deficiency, possibly by increasing 24-hydroxylase activity.

• #59 Osteomalacia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551616/

  Hypophosphatemia or Hypocalcemia […] Renal tubular acidosis, such as in Fanconi syndrome, alters ion absorption and excretion. […] Multiple intravenous iron infusions have been found to cause hypophosphatemia and osteomalacia. […] Tumor-induced osteomalacia, also known as oncogenic osteomalacia, is a rare acquired paraneoplastic disease characterized by hypophosphatemia, elevated or inappropriately normal levels of fibroblast growth factor 23, and renal phosphate wasting. […] Tumor-induced osteomalacia is commonly caused by benign tumors involving the skin, muscles, bones of the extremities, or the paranasal sinuses. […] Medications […] Antiepileptic drugs, including phenobarbital, phenytoin, and carbamazepine, enhance the catabolism of calcidiol via induction of cytochrome P450 activity. […] Isoniazid, rifampicin, and theophylline may also precipitate vitamin D deficiency in the same manner as antiepileptic medications. […] Antifungal agents such as ketoconazole increase vitamin D requirements by inhibiting 1-alpha-hydroxylase. […] Long-term corticosteroid use also has implications for vitamin D deficiency, possibly by increasing 24-hydroxylase activity.

• #60 Osteomalacia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551616/

  Hypophosphatemia or Hypocalcemia […] Renal tubular acidosis, such as in Fanconi syndrome, alters ion absorption and excretion. […] Multiple intravenous iron infusions have been found to cause hypophosphatemia and osteomalacia. […] Tumor-induced osteomalacia, also known as oncogenic osteomalacia, is a rare acquired paraneoplastic disease characterized by hypophosphatemia, elevated or inappropriately normal levels of fibroblast growth factor 23, and renal phosphate wasting. […] Tumor-induced osteomalacia is commonly caused by benign tumors involving the skin, muscles, bones of the extremities, or the paranasal sinuses. […] Medications […] Antiepileptic drugs, including phenobarbital, phenytoin, and carbamazepine, enhance the catabolism of calcidiol via induction of cytochrome P450 activity. […] Isoniazid, rifampicin, and theophylline may also precipitate vitamin D deficiency in the same manner as antiepileptic medications. […] Antifungal agents such as ketoconazole increase vitamin D requirements by inhibiting 1-alpha-hydroxylase. […] Long-term corticosteroid use also has implications for vitamin D deficiency, possibly by increasing 24-hydroxylase activity.

• #61 Rickets and Osteomalacia Causes: Why Do These Diseases Occur?

  https://ce4rt.com/rad-tech-talk/rickets-and-osteomalacia-causes/?srsltid=AfmBOorARBjAjaJttEKaJICwDkyZB26IVTJ4mV8nOm1N5qF88ZQAk-4D

  Deficiency of vitamin D is a common cause of rickets and osteomalacia. […] Sunlight exposure is important to prevent vitamin D deficiency. […] In addition to vitamin D deficiency, rickets and osteomalacia causes include a deficiency of phosphate in the body. A form of the disease called hypophosphatemic rickets is genetic and is inherited as an X-linked disorder. More commonly, however, the phosphate deficiency that leads to rickets and osteomalacia is the result of non-genetic factors. The kidneys in some individuals have a reduced ability to retain phosphate, putting them at risk of phosphate deficiency. Diseases which damage the renal tubules can lead to this condition as this is the site where phosphate is reabsorbed by the kidneys. […] In addition, diet can play a role in the development of phosphate deficiency. People who consume large amounts of aluminum hydroxide in antacids may suffer from phosphate deficiency due to the absorption of dietary phosphate being prevented by these drugs. Certain drugs are known to interfere with bone mineralization or phosphate absorption. Rickets can develop as a result of inherited or acquired defects in the kidney tubule that affect acid secretion. Finally, some tumors secrete substances that promote the loss of phosphate from the body, leading to what is known as oncogenic or tumor-induced osteomalacia. These are relatively rare rickets and osteomalacia causes.

• #62 Rickets – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rickets/symptoms-causes/syc-20351943

  Factors that can increase a child’s risk of rickets include: Darker skin pigmentation. Brown or Black skin has more of the pigment melanin, which lowers the skin’s ability to produce vitamin D from sunlight. Mother’s vitamin D deficiency during pregnancy. A baby born to a mother with serious vitamin D deficiency can be born with symptoms of rickets or develop them within a few months after birth. Northern latitudes. Children who live in geographical locations where there is less sunshine are at higher risk of rickets. […] If not treated, rickets can lead to: Failure to grow. Bone deformities. Dental defects. Seizures.

• #63

  https://www.nhs.uk/conditions/rickets-and-osteomalacia/

  Rickets is a condition that affects bone development in children. It causes bone pain, poor growth and soft, weak bones that can lead to bone deformities. […] A lack of vitamin D or calcium is the most common cause of rickets. Vitamin D largely comes from exposing the skin to sunlight, but it’s also found in some foods, such as oily fish and eggs. Vitamin D is essential for the formation of strong and healthy bones in children. […] In rare cases, children can be born with a genetic form of rickets. It can also develop if another condition affects how vitamins and minerals are absorbed by the body. […] Any child who doesn’t get enough vitamin D or calcium either through their diet, or from sunlight, can develop rickets. But the condition is more common in children with dark skin, as this means they need more sunlight to get enough vitamin D, as well as children born prematurely or taking medication that interferes with vitamin D.

• #64 Rickets – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rickets/symptoms-causes/syc-20351943

  Factors that can increase a child’s risk of rickets include: Darker skin pigmentation. Brown or Black skin has more of the pigment melanin, which lowers the skin’s ability to produce vitamin D from sunlight. Mother’s vitamin D deficiency during pregnancy. A baby born to a mother with serious vitamin D deficiency can be born with symptoms of rickets or develop them within a few months after birth. Northern latitudes. Children who live in geographical locations where there is less sunshine are at higher risk of rickets. […] If not treated, rickets can lead to: Failure to grow. Bone deformities. Dental defects. Seizures.

• #65

  https://link.springer.com/article/10.1007/s11914-017-0383-y

  Nutritional rickets and osteomalacia are common in dark-skinned and migrant populations. Their global incidence is rising due to changing population demographics, failing prevention policies and missing implementation strategies. […] The global rickets consensus recognises the equal contribution of vitamin D and dietary calcium in the causation of calcium deprivation and provides a three stage categorisation for sufficiency, insufficiency and deficiency. […] Calcium deprivation is caused by two factors, low dietary calcium and vitamin D intake. Vitamin D deficiency is pandemic in Europe, in winter affecting nearly 18% of the population, but with 371 times higher risk in dark-skinned ethnic minority groups. […] Public health research has identified traditional diets low in calcium, dark skin and cultural full body clothing, as the predominant causes of rickets and osteomalacia in sunny parts of the world such as the Indian subcontinent, the Middle East and Africa.

• #66 Rickets – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rickets/symptoms-causes/syc-20351943

  Rickets is the softening and weakening of bones in children, often because of an extreme and prolonged vitamin D or calcium deficiency. Rare inherited problems also can cause rickets. […] Rickets can occur if your child’s body doesn’t get enough vitamin D or has problems using vitamin D properly. Occasionally, not getting enough calcium or lack of calcium and vitamin D can cause rickets. […] Children who don’t get enough vitamin D from these two sources can develop a deficiency: Sunlight. Your child’s skin produces vitamin D when it’s exposed to sunlight. But children in developed countries tend to spend less time outdoors. They also are more likely to use sunscreen, which blocks the sun’s rays that trigger the skin’s production of vitamin D. […] Some children are born with or develop medical problems that affect the way their bodies absorb vitamin D. Some examples include: Celiac disease. Inflammatory bowel disease. Cystic fibrosis. Kidney problems.

• #67 Rickets – Wikipedia

  https://en.wikipedia.org/wiki/Rickets

  Rickets is a condition that results in weak or soft bones in children and may have either dietary deficiency or genetic causes. […] The most common cause of rickets is a vitamin D deficiency, although hereditary genetic forms also exist. […] This can result from eating a diet without enough vitamin D, dark skin, too little sun exposure, exclusive breastfeeding without vitamin D supplementation, celiac disease, and certain genetic conditions. […] Maternal deficiencies may be the cause of overt bone disease from before birth and impairment of bone quality after birth. […] The primary cause of congenital rickets is vitamin D deficiency in the mother’s blood. […] Exclusively breast-fed infants may require rickets prevention by vitamin D supplementation or an increased exposure to sunlight.

• #68 Rickets – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rickets/symptoms-causes/syc-20351943

  Factors that can increase a child’s risk of rickets include: Darker skin pigmentation. Brown or Black skin has more of the pigment melanin, which lowers the skin’s ability to produce vitamin D from sunlight. Mother’s vitamin D deficiency during pregnancy. A baby born to a mother with serious vitamin D deficiency can be born with symptoms of rickets or develop them within a few months after birth. Northern latitudes. Children who live in geographical locations where there is less sunshine are at higher risk of rickets. […] If not treated, rickets can lead to: Failure to grow. Bone deformities. Dental defects. Seizures.

• #69 Rickets – Wikipedia

  https://en.wikipedia.org/wiki/Rickets

  Rickets is a condition that results in weak or soft bones in children and may have either dietary deficiency or genetic causes. […] The most common cause of rickets is a vitamin D deficiency, although hereditary genetic forms also exist. […] This can result from eating a diet without enough vitamin D, dark skin, too little sun exposure, exclusive breastfeeding without vitamin D supplementation, celiac disease, and certain genetic conditions. […] Maternal deficiencies may be the cause of overt bone disease from before birth and impairment of bone quality after birth. […] The primary cause of congenital rickets is vitamin D deficiency in the mother’s blood. […] Exclusively breast-fed infants may require rickets prevention by vitamin D supplementation or an increased exposure to sunlight.

• #70 Health A to Z – Wirral Community Health and Care NHS Foundation Trust

  https://www.wchc.nhs.uk/health-care/health/rickets-and-osteomalacia/rickets-and-osteomalacia/

  Rickets is a condition that affects bone development in children. It causes bone pain, poor growth and soft, weak bones that can lead to bone deformities. […] A lack of vitamin D or calcium is the most common cause of rickets. Vitamin D largely comes from exposing the skin to sunlight, but it’s also found in some foods, such as oily fish and eggs. Vitamin D is essential for the formation of strong and healthy bones in children. […] In rare cases, children can be born with a genetic form of rickets. It can also develop if another condition affects how vitamins and minerals are absorbed by the body. […] Any child who doesn’t get enough vitamin D or calcium either through their diet, or from sunlight, can develop rickets. But the condition is more common in children with dark skin, as this means they need more sunlight to get enough vitamin D, as well as children born prematurely or taking medication that interferes with vitamin D. […] Rickets can easily be prevented by eating a diet that includes vitamin D and calcium, spending some time in sunlight, and if necessary, taking vitamin D supplements.

• #71 Osteomalacia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551616/

  Osteomalacia, a metabolic bone disorder commonly known as „soft bone disease,” results from inadequate mineralization of bone tissue due to deficiencies in vitamin D, calcium, or phosphate. This deficiency leads to weakened, softened bones, manifesting in symptoms such as bone pain, muscle weakness, and an increased risk of fractures. […] Understanding osteomalacia is critical, as early recognition and appropriate treatment can prevent the debilitating complications associated with this disorder. […] Osteomalacia is a metabolic bone disease characterized by impaired mineralization of bone matrix. […] Details of the most common and sometimes overlooked causes are as follows: […] Decreased Vitamin D Production […] Cold weather climates reduce skin sunlight exposure and cutaneous synthesis. […] Dark skin and relatively increased melanin compete with 7-dehydrocholesterol ultraviolet-B light absorption. […] Obesity can lead to increased adipose sequestration, which results in less calcidiol substrate available for activation. […] Vitamin D production decreases in older individuals, and the storage of vitamin D declines with age.

• #72 Osteomalacia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551616/

  Decreased Vitamin D Absorption […] Nutritional deficiency can cause vitamin D deficiency even with adequate sunlight exposure. […] Malabsorptive syndromes such as Crohn disease, cystic fibrosis, celiac disease, cholestasis, and surgical alteration of the gastrointestinal tract, such as gastric bypass, are associated with deficient absorption of fat-soluble vitamins A, D, E, and K. […] Altered Vitamin D Metabolism […] Chronic kidney disease leads to structural damage, loss of 1-alpha-hydroxylase, and suppressed enzymatic activity secondary to hyperphosphatemia. […] Nephrotic syndrome leads to pathologic excretion of vitamin D-binding protein, which binds to serum calcidiol. […] Liver disease, including cirrhosis and metabolic dysfunction-associated steatotic liver disease, leads to deficient production of calcidiol. […] Pregnancy is associated with decreased calcidiol levels, and the American College of Obstetricians and Gynecologists recommends treating with at least 1000 to 2000 international units daily when vitamin D deficiency is identified.

• #73 Rickets: Symptoms, Diagnosis, and Treatments

  https://www.healthline.com/health/rickets

  Rickets is a skeletal disorder thats caused by a lack of vitamin D, calcium, or phosphate. These nutrients are important for the development of strong, healthy bones. […] A vitamin D deficiency makes it difficult for your body to maintain sufficient levels of calcium and phosphate. When this occurs, your body produces hormones that cause calcium and phosphate to be released from your bones. […] Rickets is most common in children who are between 6 and 36 months old. Children are at the highest risk of rickets because theyre still growing. […] You have a higher risk of developing rickets if you eat a vegetarian diet that doesnt include fish, eggs, or milk. […] One form of rickets can be inherited. This means that the disorder is passed down through your genes. This type of rickets, called hereditary rickets, prevents your kidneys from absorbing phosphate. […] Treatment for rickets focuses on replacing the missing vitamin or mineral in the body. […] For hereditary rickets, a combination of phosphate supplements and high levels of a special form of vitamin D are required to treat the disease.

• #74 Rickets and Osteomalacia: Causes and Symptoms

  https://www.kauveryhospital.com/blog/orthopedics/vitamin-d-deficiency-causes-osteomalacia-and-rickets/

  When there is a deficiency of Vitamin D in the diet, especially in infants exclusively breast-fed and in the elderly. Vitamin D can be supplied in the diet through fortified cereals and dairy products. […] When there is inadequate exposure to sunlight, this results in inadequate production of natural Vitamin D, by the skin. […] When there is an abnormal reduction of alkalinity or occurance of chronic acidosis, in the blood, caused by renal failure. […] When complications due to Hemodialysis occur or because of chronic renal failure. […] When there is any interference with the normal metabolism of Vitamin D, such as administration of some anticonvulsant medications that are used to treat epilepsy. […] When the blood contains low levels of phosphorous (hypophosphatemia), which is caused by rare hereditary disorders. Sometimes Hypophosphatemia may be caused by continuous use of antacids that are non-absorbent.

• #75 Rickets – Wikipedia

  https://en.wikipedia.org/wiki/Rickets

  In sunny countries such as Nigeria, South Africa, and Bangladesh, there is sufficient endogenous vitamin D due to exposure to the sun. However, the disease occurs among older toddlers and children in these countries, which in these circumstances is attributed to low dietary calcium intakes due to a mainly cereal-based diet. […] Those at higher risk for developing rickets include breast-fed infants whose mothers are not exposed to sunlight, breast-fed infants who are not exposed to sunlight, and any child whose diet does not contain enough vitamin D or calcium. […] Diseases causing soft bones in infants, like hypophosphatasia or hypophosphatemia, can also lead to rickets. […] Strontium is allied with calcium uptake into bones; at excessive dietary levels strontium has a rachitogenic (rickets-producing) action.

• #76 Osteomalacia: Causes, symptoms, diagnosis, treatment, and more

  https://www.medicalnewstoday.com/articles/osteomalacia

  Along with underlying conditions, additional factors that can make it difficult for people to absorb vitamin D include: diets that are low in calcium; surgeries to promote weight loss; some medications, such as antacids, and some older antiepileptic drugs, such as topiramate; lactose intolerance, as a person will not get vitamin D from fortified milk; cirrhosis.

• #77 Rickets – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rickets/symptoms-causes/syc-20351943

  Factors that can increase a child’s risk of rickets include: Darker skin pigmentation. Brown or Black skin has more of the pigment melanin, which lowers the skin’s ability to produce vitamin D from sunlight. Mother’s vitamin D deficiency during pregnancy. A baby born to a mother with serious vitamin D deficiency can be born with symptoms of rickets or develop them within a few months after birth. Northern latitudes. Children who live in geographical locations where there is less sunshine are at higher risk of rickets. […] If not treated, rickets can lead to: Failure to grow. Bone deformities. Dental defects. Seizures.

• #78 Rickets – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rickets/symptoms-causes/syc-20351943

  Factors that can increase a child’s risk of rickets include: Darker skin pigmentation. Brown or Black skin has more of the pigment melanin, which lowers the skin’s ability to produce vitamin D from sunlight. Mother’s vitamin D deficiency during pregnancy. A baby born to a mother with serious vitamin D deficiency can be born with symptoms of rickets or develop them within a few months after birth. Northern latitudes. Children who live in geographical locations where there is less sunshine are at higher risk of rickets. […] If not treated, rickets can lead to: Failure to grow. Bone deformities. Dental defects. Seizures.

• #79 Osteomalacia and Rickets

  https://courses.washington.edu/bonephys/hypercalU/opmal2.html

  Osteomalacia means „soft bones”. Osteoid is the bone protein matrix, composed primarily of type 1 collagen. When there is insufficient mineral or osteoblast dysfunction, the osteoid does not mineralize properly, and it accumulates. […] Rickets is a problem near the joints when the bone formed by a growth plate does not mineralize. Then the growth plate becomes thick, wide and irregular. This is seen only in children because adults no longer have growth plates. However, the abnormal joints persist and adults can have deformities such as bowed legs. Most of the hereditary causes of osteomalacia appear during childhood and cause rickets. […] When children do not get enough vitamin D in their diet and also don’t get adequate sunlight exposure to their skin, they develop rickets. […] The following table lists the causes of osteomalacia and the abnormalities found in blood tests (Calcium, phosphate, 25-hydroxy-vitamin D, 1,25-dihydroxy-vitamin D, Parathyroid hormone, alkaline phosphate):

• #80 Rickets – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rickets/symptoms-causes/syc-20351943

  Factors that can increase a child’s risk of rickets include: Darker skin pigmentation. Brown or Black skin has more of the pigment melanin, which lowers the skin’s ability to produce vitamin D from sunlight. Mother’s vitamin D deficiency during pregnancy. A baby born to a mother with serious vitamin D deficiency can be born with symptoms of rickets or develop them within a few months after birth. Northern latitudes. Children who live in geographical locations where there is less sunshine are at higher risk of rickets. […] If not treated, rickets can lead to: Failure to grow. Bone deformities. Dental defects. Seizures.

• #81 Rickets and Osteomalacia: Causes and Symptoms

  https://www.massgeneral.org/children/rickets

  Rickets is a disease of growing children that affects how the growth plates of bones develop. Rickets can cause bowing of the legs and bone pain. It can also increase a child’s risk of fracture (broken bone). […] Osteomalacia affects both children and adults and is a disease in which the bones don’t contain enough bone mineral (mostly calcium and phosphate). Like rickets, osteomalacia can cause bone pain and increase the risk of fracture. […] The most common cause of rickets and osteomalacia is vitamin D deficiency (not enough vitamin D). Usually, this is due to: A diet without enough vitamin D. Insufficient vitamin D production in your skin (from having darker colored skin or keeping skin covered without sufficient sun exposure, or living in northern regions of the country). This is particularly a problem during the winter months. Some medical conditions, such as celiac disease, can affect how a child’s gut absorbs vitamin D from food. In a few cases, rickets is the result of rare genetic conditions that affect how the body uses vitamin D or phosphate.

• #82 Rickets – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rickets/symptoms-causes/syc-20351943

  Factors that can increase a child’s risk of rickets include: Darker skin pigmentation. Brown or Black skin has more of the pigment melanin, which lowers the skin’s ability to produce vitamin D from sunlight. Mother’s vitamin D deficiency during pregnancy. A baby born to a mother with serious vitamin D deficiency can be born with symptoms of rickets or develop them within a few months after birth. Northern latitudes. Children who live in geographical locations where there is less sunshine are at higher risk of rickets. […] If not treated, rickets can lead to: Failure to grow. Bone deformities. Dental defects. Seizures.

• #83 Rickets: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/985510-overview

  Rickets is a disease of growing bone that is unique to children and adolescents. It is caused by a failure of osteoid to calcify in a growing person. Failure of osteoid to calcify in adults is called osteomalacia. […] Vitamin D deficiency rickets occurs when the metabolites of vitamin D are deficient. Less commonly, a dietary deficiency of calcium or phosphorus may also produce rickets. […] During the Industrial Revolution, rickets appeared in epidemic form in temperate zones where the pollution from factories blocked the suns ultraviolet rays. Thus, rickets was probably the first childhood disease caused by environmental pollution. […] Rickets may lead to skeletal deformity and short stature. In females, pelvic distortion from rickets may cause problems with childbirth later in life. Severe rickets has been associated with respiratory failure in children.

• #84 Rickets: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/985510-overview

  Rickets is a disease of growing bone that is unique to children and adolescents. It is caused by a failure of osteoid to calcify in a growing person. Failure of osteoid to calcify in adults is called osteomalacia. […] Vitamin D deficiency rickets occurs when the metabolites of vitamin D are deficient. Less commonly, a dietary deficiency of calcium or phosphorus may also produce rickets. […] During the Industrial Revolution, rickets appeared in epidemic form in temperate zones where the pollution from factories blocked the suns ultraviolet rays. Thus, rickets was probably the first childhood disease caused by environmental pollution. […] Rickets may lead to skeletal deformity and short stature. In females, pelvic distortion from rickets may cause problems with childbirth later in life. Severe rickets has been associated with respiratory failure in children.

• #85 Rickets – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562285/

  The prognosis depends on the cause and severity of rickets. Nutritional rickets has a promising prognosis with prompt recognition and early institution of treatment. It can be cured completely within a few months from starting treatment. However, untreated patients may end with catastrophic complications. On the other hand, genetic causes of rickets mostly are not curable, and the treatment is symptomatic to improve the quality of life and management of complications.

Zobacz więcej