Rickets referred exclusively nursery growing pains, which is based on a discrepancy between the amount of calcium in bone and its assimilation in the body.
Imbalance occurs as a result of deficiency of vitamin D, which is involved in the absorption and deposition of calcium in the skeleton.
Causes and risk factors
In general, clinical signs may be rickets and other diseases, so-called rachitis-like diseases. In such cases also disturbed calcium metabolism, but there is no shortage of vitamin D.
In this case we are talking about rickets.
This disease is found everywhere, but in areas with a small amount of sunlight it happens more often.
The causes of rickets are not limited to a mere deficiency of vitamin D, so today it is considered a disease mnogofaktorym.
Most often:
- at the city, little children walking,
- in children from ecologically unfavorable cities
- children from problem families.
Risk factors are divided into three main groups.
The first group includes during pregnancy and childbirth.
Rickets usually occurs in such conditions as:
- early (before age 18) or late (35-40 years) age of the mother,
- a rare appearance in the sun during pregnancy,
- the presence of chronic conditions in the mother,
- improper diet, poor nutrition, lack of exercise during pregnancy,
- rapidDelayed or abnormal births.
Rickets is characterized for:
- children born to the third and subsequent pregnancies,
- children born to the same age,
- twins, premature babies.
The second group includes factors such as child nutrition issues since the early days.
Rickets is more common in children:
- artificial feeding, due to the incomplete assimilation of calcium and vitamin D from a mixture,
- unadapted to nutrition (cow's milk, yogurt and cream of wheat from an early age)
- with underfeeding or overfeeding.
The third group includes children with different kinds of diseases that contribute to rickets:
- fetal malnutrition,
- nervous system lesions,
- allergies, Skin diseases,
- syndrome of malabsorption in the intestines.
In addition, rickets more defeated boys smuglokozhih children from the second group of blood.
manifestations of rickets
Signs of rickets are not specific enough, then there may occur in many other childhood diseases, so their evaluation is carried out only in combination with laboratory data.
Rickets practically does not occur in infants in the first three months of life in children after a year, the main symptoms after six months.
Clinic manifested symptoms of lack of calcium that without vitamin D can not be absorbed active. In such cases, calcium leached using hormone from the skeleton.
The first manifestations of rickets are:
- increased fearfulness, flinching from the sharp sounds or turn on the light,
- increased sweating, especially on the head, clammy sweat sour smell, it occurs due to itching,
- because of the itching baby t head, the hair on the back of the head rolled out,
- decreased muscle tone, which is why he later begins to sit, crawl and walk,
- marked discrepancy between the ribs and the edges of an umbilical hernia,
- soften the edge of the fontanelle, palpated seams, large fontanelle.
In a sufficiently severe cases are marked bone changes:
- curvature tibiae X or O-shaped,
- flattening of the occiput,
- retraction of the sternum,
- changing shape of the skull with the heaving of the frontal and parietal hillocks and a receding hairline at the forehead,
- late closing fontanelle,
- late teething.
The clinical picture of rickets is complemented by specific symptoms of the internal organs:
- there convulsive readiness, convulsions,
- suffers digestion, impaired weight gain, unstable chair,
- anemia,
- decreased immunity, frequent SARS complications.
Diagnostics
Diagnosis and treatment of rickets is mainly engaged pediatricians or family doctors. Rickets is not strictly specific features, and is made by the clinic in conjunction with changes in the blood and urine tests.
From the laboratory data are shown:
- reduction of calcium - total and ionized,
- reduction of phosphorus levels,
- a sharp increase in alkaline phosphatase,
- Sulkovichu urine of a negative reaction (0ed. or none of the cross), or weakly positive (1 unit. or +).
rickets treatment
The mainstay of treatment - a vitamin D in conjunction with calcium supplementation, if little nutrition.
In addition, it is important to normalize the way of life and increase the child stay in the open air and the sun.
With proper treatment of rickets begins Docked in three or four weeks, but bone changes may persist longer.
Vitamin D is administered in therapeutic doses of 1000 to 5000 IU Sulkovicha under control sample, since an overdose of vitamin no less dangerous than a deficiency. When changing the sample in the "++", a dose considered optimum, while the sample in "+++" or "++++" it is necessary to decrease.
Important combination of vitamin D and calcium preparations, particularly if the child nutrition little calcium-containing products. It is prescribed in the form of a gluconate or calcium lactate.
In the course of treatment with rickets should include a massage and exercises to improve muscle tone and improve overall state, walking with an open face should be at least 1-2 hours a day, if possible should be stay in the sun.
prevention
Through the efforts of the doctors on the prevention of rickets, today, there is no serious and disfiguring forms.
Prophylaxis is conducted for all children from October to April in the form of prophylactic administration of a dose of vitamin D vitamin 500ME (1 drop solution) per day. Apply the oil and aqueous solutions. Water preferable for children with allergies and digestive problems.