Arch Iran Med. 2018;21(12):589-594.
PMID: 30634857
  Abstract View: 60
  PDF Download: 69

Original Article

Children With Vitamin D Deficiency: Is A Wrist X-Ray Necessary?

Mohammadreza Esmaeili Dooki 1, Leila Moslemi 1 * , Ali Akbar Moghadamnia 2, Morteza Alijanpour Aghamaleki 1, Ali Bijani 1,3, Mohammad Pornasrollah 1, Hassan Ashrafianamiri 3, Haji-Ghorban Nooreddin 1

1 Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, IR Iran
2 Department of Pharmacology, Faculty of Medicine, Babol University of Medical Sciences, Babol, IR Iran
3 Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, IR Iran
*Corresponding Author: Leila Moslemi, PhD; Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, No 19, Amirkola Children’s Hospital, Amirkola, Babol, Mazandaran Province, 47317-41151, IR Iran, Email: l Email: eilamoslemi116@yahoo.com

Abstract

Background: Rickets is failure in mineralization of growing bone and cartilage due to extreme vitamin D deficiency (VDD). The study aimed to identify rickets among vitamin D deficient children and determine any relationship between clinical findings and paraclinical evidence.

Methods: This study was conducted in two stages. In the first stage, blood was drawn from 406 children aged 30–72 months for measurement of 25(OH)D level. Of these children, 108 had 25(OH)D levels of <20 ng/dL and were evaluated physically for signs and symptoms scores (0-1) of VDD and rickets. Biochemical analysis and radiography of the child’s left wrist and hand was performed.

Results: Of the 119 children (29.67%) with 25(OH)D levels of <20 ng/dL, 42 (10.3%) had vitamin D levels of ≤15 ng/dL. There was no correlation between serum 25(OH)D level and levels of calcium (Ca) (r = −0.16), alkaline phosphatase (ALP) (r = −0.12), P (r = 0.13), and parathyroid hormone (PTH) (r = −0.15,) in children with VDD. The mean of signs and symptoms scores had no significant difference between children with (1.59 ± 0.8) and without (1.73 ± 1.01) VDD (P = 0.3). None of the children with VDD had radiographic evidence of rickets. Radiographic data showed that 69.2% (72), 10.6% (11), and 20.2% (21) of the children had delayed, normal, and advanced bone age, respectively.

Conclusion: Abnormal radiological findings of rickets were not found on wrist X-rays. Thus, this investigation is not necessary within the range of vitamin D levels described in the current study.

Cite this article as: Esmaeili Dooki M, Moslemi L, Moghadamnia AA, Alijanpour Aghamaleki M, Bijani A, et al. Children with vitamin d deficiency: is a wrist x-ray necessary? Arch Iran Med. 2018;21(12):589–594.
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Submitted: 03 Jun 2017
Accepted: 07 Oct 2018
First published online: 01 Dec 2018
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