Rickets is not all the same: know the types of the disease

Rickets cases may all look the same, but they are not. As explained by pediatric orthopedist Natasha Vogel, it is possible to basically divide them into two large groups:

• Hypocalcemic: when there is a lack of vitamin D and calcium in the body;
• Hypophosphatemic: characterized by phosphorus deficiency.

There are also internal subdivisions, which serve to indicate in more detail the cause of the disease. When it is linked to low nutrient intake, for example, rickets can be called nutritional. When the problem comes from the genes, it is classified as genetic.

The fact is that hypocalcemia usually has nutritional causes, while hypophosphatemic is more associated with genetic disorders that lead to the loss of phosphate by the kidneys. Examples include disorders linked to changes in the X chromosome, which cause rickets in one in every 20,000 people worldwide, and are therefore considered rare.

Why is this separation important?

The type of rickets will determine how it should be treated, either by replacing vitamin D, calcium, phosphorus and the use of other medications or, then, by changing lifestyle habits. This is precisely why the existence of this classification is so important.

It is generally made based on the patient’s food, family and health history, in addition to the use of imaging exam results (such as radiography) and laboratory tests (such as blood and urine), which serve to assess the amount of calcium, phosphorus, vitamin D, alkaline phosphatase and parathyroid hormone (PTH) in the body.

“It is the combination of all this information that determines the type of disease and, consequently, the most appropriate treatment for each case”, reinforces orthopedist Natasha Vogel.

Early diagnosis can make all the difference.

Ideally, with the onset of symptoms, the diagnosis should be made as soon as possible, as it is essential for starting treatment and can consequently improve the patient’s quality of life, mobility and pain, in addition to to reduce the risk of sequelae, such as skeletal deformities.

Doctor Natasha recommends keeping an eye on possible signs of the disease, which include bone pain, slow growth, teething delays and weakening of bones and tooth enamel. The most common is that they appear in children between six and 36 months of age, since, at this stage, bone growth happens very quickly.