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Comment: Seizures as the presenting feature of rickets in an infant

Christopher T Cowell
Med J Aust 2003; 178 (9): . || doi: 10.5694/j.1326-5377.2003.tb05294.x
Published online: 5 May 2003

Comment: Nutritional rickets is highly prevalent in countries such as Mongolia, Tibet and China1 where winter sunlight is reduced and there is no universal vitamin D supplementation. Paradoxically, rickets is also prevalent in developing countries in the tropics and subtropics where sunlight is unlikely to be a limiting factor. Low calcium intakes (including vegetarian diets), prolonged breast feeding, and covering of the skin may all contribute.2,3




Correspondence: 

  • 1. Du X, Greenfield H, Fraser DR, et al. Vitamin D deficiency and associated factors in adolescent girls in Beijing. Am J Clin Nutr 2001; 74: 494-500.
  • 2. Pettifor JM. Rickets. Calcif Tissue Int 2002; 70: 398-399.
  • 3. Thacher TD, Fischer PR, Pettifor JM, et al. A comparison of calcium, vitamin D, or both for nutritional rickets in Nigerian children. N Engl J Med 1999; 341: 563-568.
  • 4. Kreiter SR, Schwartz RP, Kirkman HN Jr, et al. Nutritional rickets in African American breast-fed infants. J Pediatr 2000; 137: 153-157.
  • 5. Pillow JJ, Forrest PJ, Rodda CP. Vitamin D deficiency in infants and young children born to migrant parents. J Paediatr Child Health 1995; 31: 180-184.
  • 6. Abrams SA. Nutritional rickets: an old disease returns. Nutr Rev 2002; 60: 111-115.
  • 7. Mason RS, Diamond TH. Vitamin D deficiency and multicultural Australia. Med J Aust 2001; 175: 236-237. <MJA full text>
  • 8. Holick MF. Vitamin D: the underappreciated D-lightful hormone that is important for skeletal and cellular health. Curr Opin Endocrinol Diabetes 2002; 9: 87-98.
  • 9. Clements MR, Fraser DR. Vitamin D supply to the rat fetus and neonate. J Clin Invest 1988; 81: 1768-1773.
  • 10. Grover SR, Morley R. Vitamin D deficiency in veiled or dark-skinned pregnant women. Med J Aust 2001; 175: 251-252. <MJA full text>
  • 11. Nozza JM, Rodda CP. Vitamin D deficiency in mothers of infants with rickets. Med J Aust 2001; 175: 253-255. <MJA full text>

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