Patient's question:
My child is 7 years old. He was born with hypophosphatemic rickets with D deficiency. After treatment, he was left with mild sequelae, slightly bent legs. Hello, will this condition affect her height? What kind of assistance is needed: Hello, will this condition affect her height...Doctor's answer:
① Non-specific neuro symptoms. They often occur again in the early stages of rickets, in children under 1 year old. There may be night terrors, night crying, restlessness, disturbed deep sleep, sweating, and acne on the occipital region. As the condition progresses, symptoms such as muscle relaxation, abdominal distension, anemia, and hepatosplenomegaly may reappear. ② Changes in the skeleton are the main symptoms of this disease. For example, between 3 to 6 months, symptoms such as softened skull bones, square skulls, delayed closure of the anterior fontanelle may appear. As the condition worsens, additional symptoms like beaded ribs, hand and foot bracelets, and costal grooves (Harrison's sulci) may develop. Long-term and severe rickets can lead to severe skeletal deformities such as pigeon chest, funnel chest, X-shaped legs, O-shaped legs, or kyphosis and scoliosis. ③ Blood tests can show changes. In the early stages, blood calcium levels are normal, while blood phosphorus levels are slightly low, and alkaline phosphatase levels decrease. In the acute phase, both blood calcium and phosphorus levels rise, and a calcium-phosphorus product higher than 30 can help confirm the diagnosis. ④ X-ray changes are highly helpful in confirming the diagnosis. They can reflect additional skeletal coalition pathological changes. Typical X-ray images show widened metaphyseal ends of long bones, blurred early fibrous preparatory lines, cup-shaped changes in late bone ends forming a brush-like appearance, disappearance of fibrous preparatory bands, sparse bone density, and sometimes visible fractures or deformities. ⑤ The goal of treatment is to suppress the remission phase to prevent deformities and complications. General treatment includes increasing outdoor activities, getting more sunlight, paying attention to nutrition, and proper feeding. Medication treatment during the remission phase involves daily oral vitamin supplementation. Those who cannot take oral medication may receive vitamin D2 or D3 injections, but this should not be used routinely. Later, more sunlight exposure during summer and autumn is recommended, with appropriate vitamin D and calcium supplementation during winter and spring. Prevention involves enhancing hygiene and medical care, promoting breastfeeding, and encouraging sunlight exposure. During winter and spring, oral cod liver oil and calcium tablets can be taken.