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Vitamin-D Resistant Rickets A LONG-TERM CLINICAL STUDY OF ELEVEN PATIENTS
JORGE TAPIA; GENEVIEVE STEARNS; IGNACIO V. PONSETI
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From the Department of Orthopedic Surgery, College of Medicine, State University of Iowa, Iowa City
1964 by The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 1964 Jul 01;46(5):935-958
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Abstract

The regulation of vitamin-D dosage by means of twenty-four-hour urinary calcium values is relatively simple and requires no unusual laboratory procedures. If carefully applied, partial roentgenographic healing can occur and this status can be maintained permitting a nearly normal rate of growth and avoidance of hypervitaminosis D.

The importance of avoiding hypervitaminosis D is stressed. Repeated swings from hypovitaminosis to hypervitaminosis D merely alternates one disturbance of bone metabolism for another; both deplete the skeleton. Adequate therapy must maintain the child as nearly normal as possible, despite the chronic hypophosphatemia.

Under adequate vitamin-D therapy the leg deformities may improve but in our cases did not correct completely. Surgical correction is usually necessary. However, this is indicated only after regulation with adequate vitamin-D therapy. The deformities often recur if the therapy is interrupted or is grossly inadequate.

The parents are always warned that this is a chronic metabolic disease which must be followed throughout life and is especially hazardous during growth for the prevention of deformities and the maintenance of a normal rate of growth, but may recur in later years. The general practitioner should also be informed that children whose rickets does not heal promptly with customary doses of vitamin D are not suffering from simple rickets and should be referred to clinics where their disease can be treated and followed adequately.

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    Topics

    rickets ; vitamin d
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    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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