A Case of Vitamin D-Dependent Rickets, Type 1

제 1형 비타민 D 의존성 구루병 1례

  • Hur, Ji Hye (Department of Pediatrics, College of Medicine, Inje University) ;
  • Lee, Chong Guk (Department of Pediatrics, College of Medicine, Inje University) ;
  • Sur, Chung Wook (Department of Diagnostic Radiology, College of Medicine, Inje University)
  • 허지혜 (인제대학교 의과대학 소아과학교실) ;
  • 이종국 (인제대학교 의과대학 소아과학교실) ;
  • 서정욱 (인제대학교 의과대학 진단방사선과학교실)
  • Received : 2004.12.27
  • Accepted : 2005.03.09
  • Published : 2005.06.15

Abstract

"Rickets" is the term applied to impaired mineralization at epiphyseal growth plate, resulting in deformity and impaired linear growth of long bones. Rickets may arise as a result of vitamin D deficiency or abnormality in metabolism. Vitamin D-dependent rickets(VDDR) is rare autosomal recessive disorder in which affected individuals have clinical features of vitamin D deficiency. In 1961, Prader first described this disorder including severe clinical features of rickets, such as hypophosphatemia, hypocalcemia, muscle weakness and seizure. Two distinctive hereditary defects, type I VDDR and type II VDDR have been recognized in vitamin D metabolism. Type I VDDR may be due to congenital defects of renal 1 ${\alpha}$-hydroxylase, the enzyme responsible for conversion of $25(OH)D_3$. These patients have low to detectable $1,25(OH)_2D_3$ in presence of normal to raised $25(OH)D_3$. In type II VDDR, renal production of $1,25(OH)_2D_3$ is intact but $1,25(OH)_2D_3$ is not used effectively and target organ resistant to $1,25(OH)_2D_3$ is respectively derived from the abnormality in the vitamin D receptor. We report a case of a 25 month-old girl with typical clinical features of VDDR type I rickets, hypocalcemia, increased alkaline phosphatase and secondary hyperparathyroidism.

저자들은 구루병의 가족력이 있으면서 구루병의 전형적인 임상소견과 저칼슘혈증, 알칼라인 포스파타제의 상승, 2차적인 부갑상선 기능 항진증을 보인 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

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