A major health problem facing immigrant children: nutritional rickets
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Erdal Kurnaz
,
Semra Çetinkaya
,
Selin Elmaoğulları
Abstract
Objectives
Nutritional rickets (NR) is still an important problem and one which increasing influxes of immigrants are further exacerbating. This study evaluated cases of mostly immigrant children followed up with diagnoses of NR in our pediatric endocrinology clinic.
Methods
Details of 20 cases diagnosed with NR between 2017 and 2020 were retrieved from file records.
Results
Twenty (11 male) cases were included in the study. Three (15%) were Turkish nationals and the others (85%) were immigrants. Hypocalcemia and hypophosphatemia were detected in 17 and 13, respectively. Alkaline phosphatase (ALP) values were normal in two cases, while ALP and parathyroid hormone (PTH) values were elevated in all other cases, and PTH levels were very high (473.64 ± 197.05 pg/mL). 25-hydroxyvitamin D levels were below 20 ng/mL in all cases. Patients with NR received high-dose long-term vitamin D or stoss therapy. Six patients failed to attend long-term follow-up, while PTH and ALP levels and clinical findings improved at long-term follow-up in the other 14 cases.
Conclusions
The elevated PTH levels suggest only the most severe cases of NR presented to our clinic. Clinically evident NR is therefore only the tip of the iceberg, and the true burden of subclinical rickets and osteomalacia remains unidentified. Public health policies should therefore focus on universal vitamin D supplementation and adequate dietary calcium provision, their integration into child surveillance programs, adequate advice and support to ensure normal nutrition, exposure to sunlight, and informing families of the increased risk not only for resident populations but also for refugee and immigrant children.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: The local Institutional Review Board deemed the study exempt from review.
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© 2021 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Editorial
- Obesity after the Covid-19 pandemic and beyond
- Review Article
- Clinical profile and management challenges of disorders of sex development in Africa: a systematic review
- Original Articles
- Development and validation of a mobile application for point of care evaluation of growth failure
- Children-Dietary Inflammatory Index (C-DII), cardiometabolic risk, and inflammation in adolescents: a cross-sectional study
- Accelerated pubertal onset in short children with delayed bone age
- Screening for hypophosphatasia: does biochemistry lead the way?
- Subcutaneous regular insulin use for the management of diabetic ketoacidosis in resource limited setting
- NPR2 gene variants in familial short stature: a single-center study
- The effect of the COVID-19 pandemic on metabolic control in children with type 1 diabetes: a single-center experience
- Evaluating a standardized protocol for the management of diabetes insipidus in pediatric neurosurgical patients
- Development and assessment of a low-health-literacy, pictographic adrenal insufficiency action plan
- Effect of insulin resistance on lung function in asthmatic children
- A major health problem facing immigrant children: nutritional rickets
- Clinical profile, etiology, and diagnostic challenges of primary adrenal insufficiency in Sudanese children: 14-years’ experience from a resource limited setting
- Non-inferiority of liquid thyroxine in comparison to tablets formulation in the treatment of children with congenital hypothyroidism
- Short Communication
- Increased frequency of idiopathic central precocious puberty in girls during the COVID-19 pandemic: preliminary results of a tertiary center study
- Case Reports
- Gordon syndrome caused by a CUL3 mutation in a patient with short stature in Korea: a case report
- Nitisinone treatment during two pregnancies and breastfeeding in a woman with tyrosinemia type 1 – a case report
- Myxedema crisis and ovarian hyperstimulation in a child with Down syndrome
- First successful concomitant therapy of immune tolerance induction therapy and desensitization in a CRIM-negative infantile Pompe patient
Artikel in diesem Heft
- Frontmatter
- Editorial
- Obesity after the Covid-19 pandemic and beyond
- Review Article
- Clinical profile and management challenges of disorders of sex development in Africa: a systematic review
- Original Articles
- Development and validation of a mobile application for point of care evaluation of growth failure
- Children-Dietary Inflammatory Index (C-DII), cardiometabolic risk, and inflammation in adolescents: a cross-sectional study
- Accelerated pubertal onset in short children with delayed bone age
- Screening for hypophosphatasia: does biochemistry lead the way?
- Subcutaneous regular insulin use for the management of diabetic ketoacidosis in resource limited setting
- NPR2 gene variants in familial short stature: a single-center study
- The effect of the COVID-19 pandemic on metabolic control in children with type 1 diabetes: a single-center experience
- Evaluating a standardized protocol for the management of diabetes insipidus in pediatric neurosurgical patients
- Development and assessment of a low-health-literacy, pictographic adrenal insufficiency action plan
- Effect of insulin resistance on lung function in asthmatic children
- A major health problem facing immigrant children: nutritional rickets
- Clinical profile, etiology, and diagnostic challenges of primary adrenal insufficiency in Sudanese children: 14-years’ experience from a resource limited setting
- Non-inferiority of liquid thyroxine in comparison to tablets formulation in the treatment of children with congenital hypothyroidism
- Short Communication
- Increased frequency of idiopathic central precocious puberty in girls during the COVID-19 pandemic: preliminary results of a tertiary center study
- Case Reports
- Gordon syndrome caused by a CUL3 mutation in a patient with short stature in Korea: a case report
- Nitisinone treatment during two pregnancies and breastfeeding in a woman with tyrosinemia type 1 – a case report
- Myxedema crisis and ovarian hyperstimulation in a child with Down syndrome
- First successful concomitant therapy of immune tolerance induction therapy and desensitization in a CRIM-negative infantile Pompe patient
