• Title/Summary/Keyword: rickets

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Rickets caused by vitamin D deficiency in calves (송아지에서 비타민 D 결핍에 의한 구루병 증례 보고)

  • Kim, Ji-Hyeon;Lee, Kyunghyun;Jung, Ji-Youl;Yang, Siyeon;Lee, Hyunkyoung;So, ByungJae;Choi, Eunjin
    • Korean Journal of Veterinary Service
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    • v.40 no.4
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    • pp.281-285
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    • 2017
  • Six to seven-month-old 10 beef calves in 140-head beef cattle farm in Gimpo-si, Gyeonggi-do were suffered from ataxia and astasia. Two of them were submitted to Animal and Plant Quarantine Agency for diagnosis in July 9, 2015. At necropsy, the radius and tibia of both calves showed irregular thickening and hemorrhage of the physis in addition to hemorrhage and disruption of trabeculae in metaphysis. Histopathologically the physis showed irregular tongues of cartilage remaining the metaphysis. Disorganization, hemorrhage and fibrosis were observed in metaphyseal and epiphyseal bones. The serum 25-hydroxyvitamin $D_3$ ($D_3$) and calcium levels were lower than normal range. In addition, the serum $D_3$ levels in the other 9 calves of the same farm were lower than normal levels. Based on the pathological examination and serum chemistry measurements, we diagnosed this case as rickets caused by vitamin D deficiency in calves.

X-LINKED DOMINANT HYPOPHOSPHATAEMIC RICKETS: 13 YEARS FOLLOW-UP STUDY (X 염색체 우성 저인산혈증성 구루병: 13년간의 치험례)

  • Ha, Na;Kim, Youngjin;Kim, Hyunjung;Nam, Soonhyeun
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.13 no.1
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    • pp.14-18
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    • 2017
  • X-linked dominant hypophosphataemic rickets(XLHR) is a hereditary disease generally transmitted as an X-linked dominant trait. Oral manifestations include poorly mineralized dentin, enlarged pulp chambers and root canals, early tooth loss. Also, spontaneous dental abscesses could occur in the absence of a history of trauma or caries. This report describes the clinical finding and dental treatment of a child, who came to the hospital for treatment caries but was refered to pediatrics because the child showed clinically short of status, bow-leg and radiographically enlarged pulp chamber and canal, there as diagnosed as XLHR. After the diagnosis, 13 years follow-up and treatment were performed.

A Case of Type I Vitamin D-dependent Rickets with Unilateral Aplasia of Kidney (일측성 신장 무형성을 동반한 제 1형 비타민 D 의존성 구룻병 1례)

  • Lim, Dong-Hee;Jung, Ji-In;Yim, Hyung-Eun;Eun, Baik-Lin;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.111-115
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    • 2008
  • Vitamin D-dependent rickets(VDDR) is a rare autosomal disorder, characterized by hypocalcemia, hypophosphatemia, increased alkaline phosphatase, secondary hyperparathyroidism and many other clinical features. Type I VDDR is due to congenital defects of renal 1${\alpha}$-hydroxylase, the enzyme responsible for the conversion of 25-(OH)D3 to 1,25-$(OH)_2D3$. Type II VDDR arise from target organ resistance to 1,25-$(OH)_2D3$. Unilateral renal aplasia is generally thought to result from a lack of induction of the metanephric blastema from the ureteral bud, which may be secondary to ureteral bud maldevelopment and/or to a problem with the formation of the mesonephric duct. The incidence of unilateral renal aplasia is approximately 1/500-3,200. Type 1 VDDR associated with unilateral renal aplasia has not been reported yet. Thus we report a case of a 3 month old female infant diagnosed as type 1 VDDR with unilateral aplasia of kidney.

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Korean Guidelines for Breast-fed Infants for Vitamin D Supplements (모유수유아의 비타민 D 섭취에 대한 한국형 가이드라인 제안)

  • Kim, Hyun-Ji;Cho, Sun-Young
    • The Journal of Pediatrics of Korean Medicine
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    • v.26 no.1
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    • pp.70-78
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    • 2012
  • Objectives Recently, vitamin D supplements to breast-fed infants are being encouraged in Korea, and other countries. However, the reliability and validity assessment of supplements is insufficient. Therefore, this study suggests new Korean guidelines for vitamin D supplements of breast-fed infant. Methods The roles of Vitamin D for bone metabolism in children and the correlation between breast milk and Vitamin D were examined throughout domestic and international literature review. In addition, the efficacy and safety of vitamin D supplements were reviewed. Results Preventive effects of rickets by vitamin D supplementation remain unclear. Furthermore, concerns about the safety of vitamin D supplements intake have been raised. Korean guideline suggests breast-fed infants can get vitamin D through the skin safely, but maternal intake of vitamins through sunbath and diet is more effective and safe. Conclusions Limiting sunlight excessively and applying foreign countries' medical guideline for vitamin D supplements are not valid to apply as a domestic guideline for Korean breast-fed infants without considering ethnic and cultural characteristics.

An Anesthetic Management in a Pedodontic Patient with Lowe Syndrome - A case report - (Lowe 증후군을 동반한 소아치과 환자의 전신 마취 경험 -증례 보고-)

  • Choi, Young-Kyoo;Oh, Jae-Yeol;Kim, Dong-Ok;Shin, Ok-Young;Lee, Keung-Bo
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.2 no.1 s.2
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    • pp.33-37
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    • 2002
  • The oculo-cerebro-renal syndrome of Lowe (Lowe syndrome) is an X-linked recessive disorder involving the eyes, nervous systems, and kidneys. The clinical manifestation of this syndrome is characterized by congenital cataracts, glaucoma, seizure disorder, psychomotor growth retardation, hypotonia, renal tubular acidosis, aminoaciduria, rickets, and osteoporosis. We report a 5-year old boy underwent general anesthesia for the treatment of multiple dental carries. During intraoperative period, marked metabolic acidosis was noted and such acidosis was partially corrected by hyperventilation. We suggest that patients with Lowe's syndrome should be attention and treated to possible anesthetic hazards such as metabolic acidosis due to renal tubular dysfunction, rise of intraocular pressure in patient with glaucoma, the fragility of the bone structures due to rickets and osteoporosis.

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Recent concepts on vitamin D in children and adolescents (소아청소년기의 비타민 D에 대한 최신 지견)

  • Yang, Hye Ran;Seo, Jeong Wan;Kim, Yong Joo;Kim, Jae Young;Ryoo, Eell;Sim, Jae Geon;Yom, Hye Won;Chang, Ju Young;Jung, Ji A;Choi, Kwang Hae
    • Clinical and Experimental Pediatrics
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    • v.52 no.10
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    • pp.1082-1089
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    • 2009
  • Vitamin D is an important fat-soluble vitamin that functions as a prohormone and affects bone mineralization and calcium homeostasis. Vitamin D deficiency causesboth musculoskeletal manifestations, including rickets, and extra-musculoskeletal symptoms. Because vitamin D is naturally present in only some foods, intake of daily foods cannot meet the dietary reference intake for vitamin D. Sunlight is the main source of vitamin D in humans therefore, the lack of sunlight can easily cause vitamin D deficiency in children and adolescents. Vitamin D deficiency can be diagnosed on the basis ofits typical clinical manifestation, laboratory tests, and radiologic findings. Detection of vitamin D deficiency in children or adolescents necessitates the simultaneous administration of vitamin D and calcium supplements. To prevent vitamin D deficiency, 200 IU of daily vitamin D intake is recommended in infants, and 400 IU of daily vitamin D intake is recommended in Korean children and adolescents.

MALDI-MS-Based Quantitative Analysis of Bioactive Forms of Vitamin D in Biological Samples

  • Ahn, Da-Hee;Kim, Hee-jin;Kim, Seong-Min;Jo, Sung-Hyun;Jeong, Jae-Hyun;Kim, Yun-Gon
    • Korean Chemical Engineering Research
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    • v.58 no.1
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    • pp.106-112
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    • 2020
  • Analyzing vitamin D levels is important for monitoring health conditions because vitamin D deficiency is associated with various diseases such as rickets, osteomalacia, cardiovascular disorders and some cancers. However, vitamin D concentration in the blood is very low with optimal level of 75 nmol/L, making quantitative analysis difficult. The objective of this study was to develop a highly sensitive analysis method for vitamin D using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-MS). 25-hydroxyvitamin D (25(OH)D), which has been used as an indicator of vitamin D metabolites in human biofluids was chemically derivatized using a secosteroid signal enhancing tag (SecoSET) with powerful dienophile and permanent positive charge. The SecoSET-derivatized 25(OH)D provided good linearity (R2 > 0.99) and sensitivity (limit of quantitation: 11.3 fmol). Chemical derivatization of deuterated 25-hydroxyvitamin D3 (d6-25(OH)D3) with SecoSET enabled absolute quantitative analysis using MALDI-MS. The highly sensitive method could be successfully applied into monitoring of quantitative changes of bioactive vitamin D metabolites after treatment with ketoconazole to inhibit 1α-hydroxylase reaction related to vitamin D metabolism in human breast cancer cells. Taken together, we developed a MALDI-MS-based platform that could quantitatively analyze vitamin D metabolites from cell products, blood and other biofluids. This platform may be applied to monitor various diseases associated with vitamin D deficiency such as rickets, osteomalacia and breast cancer.

Marasmus and Kwashiorkor by Nutritional Ignorance Related to Vegetarian Diet and Infants with Atopic Dermatitis in South Korea (아토피피부염 영아의 영양장애 사례보고와 채식주의에 관한 고찰)

  • Chung Sang-Jin;Han Young Shin;Chung Seung Won;Ahn Kang-Mo;Park Hwa Young;Lee Sang Il;Cho Young Yeun;Choi Hye Mi
    • Journal of Nutrition and Health
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    • v.37 no.7
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    • pp.540-549
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    • 2004
  • Infants and children with food related Atopic Dermatitis (AD) need extra dietary efforts to maintain optimal nutrition due to food restriction to prevent allergy reactions. However, nutrition ignorance and food faddism make patients even more confused and practice desirable diet more difficult. The objective of this study was to report the AD patients' malnutrition cases in Korea. We report on 2 cases of severe nutritional deficiency caused by consuming macrobiotic diets which avoid processed foods and most animal foods, i.e. one of vegetarian diet. Case 1, a 12-month-old male child, was admitted with severe marasmus. Because of a history of AD, he was started on mixed grain porridge at 3 months without any breast milk or formula feeding. His caloric intake was 66% and protein intake was 69% of the recommended dietary allowance. Patient's height and weight was under 3th percentile. On admission the patient was unable to crawl or roll over. Case 2, a 9-month-old AD female patient, was diagnosed with kwashiorkor and rickets. She was also started on mixed grain porridge at 100 days due to AD. Her caloric intake has been satisfied recommended dietary allowance until 7 months, however, she conducted sauna bath therapy and reduced both energy and protein intake at 8 months. The amount of protein intake for case 2 was higher than recommended dietary allowance, but, sauna therapy and severe AD with intakes of low guality protein may increase patient's protein requirement resulting in kwashiorkor. Case 2 patient's height and weight was on 3th percentile. Both cases showed low intake of calcium, iron, zinc, vitamin A, vitamin E and especially very low intake of vitamin B$_{12}$ and vitamin D. Allergy tests for certain foods had not done prior to admission for both cases. They followed the dietary advise operated by macrobiotic diet internet site. In conclusion, AD infants' parents and caregivers should contact a pediatrician trained as a specialist in allergy for accurate diagnosis. For infant patients, breast or formula feeding including hypoallergenic formula should be continued until their one year of age. When certain foods need to be restricted or to follow special diets such as vegetarian diet, consultation with pediatrician and dietitian is needed.d.

Clinical characteristics and prevalence of vitamin D insufficiency in children less than two years of age

  • Yoon, Ji-Hyun;Park, Cheong-Soo;Seo, Ji-Young;Choi, Yun-Sun;Ahn, Young-Min
    • Clinical and Experimental Pediatrics
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    • v.54 no.7
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    • pp.298-303
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    • 2011
  • Purpose: To evaluate the clinical characteristics of vitamin D deficiency and its association with iron deficiency anemia (IDA). Methods: A total of 171 children aged less than two years underwent 25-hydroxyvitamin $D_3$ tests between January 2007 and July 2009. The study was classified into two groups: normal and vitamin D insufficiency, by their vitamin 25-hydroxyvitamin $D_3$ levels. Results: In total, 120 children were in the normal group (mean age, body weight and heights $12.5{\pm}7.0$, $9.3{\pm}0.9$ kg and $76.8{\pm}1.1$ cm), and 51 children in the vitamin D insufficiency group ($9.9{\pm}5.4$ months, $9.0{\pm}0.9$ kg and $75.1{\pm}0.9$ cm). Vitamin D insufficiency was most commonly diagnosed in the spring (44%). The proportion of complete breast-feeding was higher in the insufficiency (92%), and 25.5% of the children in the deficient group also experienced IDA compared that 12% of normal group. Ten children in the insufficiency group experienced bony changes. Six children received calcitriol medication in the normal group, in whom the mean vitamin 25-hydroxyvitamin $D_3$ level increased from $39.6{\pm}14.6$ ng/mL (pre-medication) to $41.8{\pm}17.2$ ng/mL (post-medication), and 13 in the insufficiency group, in whom the mean vitamin 25-hydroxyvitamin $D_3$ increased from $20.7{\pm}7.0$ ng/mL to a mean post-treatment level of $43.7{\pm}23.8$ ng/mL. Conclusion: This study demonstrated that approximately 30% of children aged ${\leq}2$ years experienced vitamin D insufficiency associated with subclinical rickets. Many children also experienced concurrent IDA. Guidelines for vitamin D supplement in such children must therefore be established.

Current status in calcium biofortification of crops (작물의 생합성 칼슘 함량 증대 연구 현황)

  • Lee, Jeong-Yeo;Nou, Ill-Sup;Kim, Hye-Ran
    • Journal of Plant Biotechnology
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    • v.39 no.1
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    • pp.23-32
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    • 2012
  • Calcium is an essential nutrient for living organisms, with key structural and signaling roles. Its deficiency in plants can result in poor biotic and abiotic stress tolerance as well as reduced crop quality and yield. Calcium deficiency in humans causes various diseases such as osteoporosis and rickets. Biofortification of calcium in various food crops has been suggested as an economic and environmentally advantageous method to enhance human intake of calcium. Recent efforts to increase the levels of calcium in food crops have used calcium/proton antiporters ($CAXs$) and modified one to increase calcium transport into vacuoles through genetic engineering. It has been reported that overall calcium content of transgenic plants has been increased in their edible portions with some adverse effects. In conclusion, biofortification of calcium will add more value in crops as well as will be beneficial for animal and human. Therefore, more fundamental studies on the mechanisms of calcium ion storage and transporting are essential for more effective calcium biofortification.