Endocrine Abstracts

Vitamin D deficiency causes rickets in children and osteomalacia in adolescents. Rickets cases are still being reported in the Arab gulf area and worldwide. The clinical spectrum ranges from subclinical (asymptomatic) form to severe symptoms and signs including progressive bone pains, myopathy, waddling gait and bone deformities.

We recorded the clinical, biochemical and radiological data 50 adolescents with severe vitamin D deficiency. Clinical symptoms included pain in weight bearing joints, back, thighs, knees, and calves (36/50) difficulty walking and/or climbing stairs and/or running (12/50), muscle cramps and/or facial twitches and/or carpo-pedal spasms (21/50). Significant inverse correlation was detected between serum 25OHD and PTH concentrations (r=0.447, P<0.01). Two radiological patterns have been identified. In pattern (I) (n=8),(Fig -right) the lesions appear as metaphyseal multilocular cystic lesion with sclerotic margins, located subcortically without significant cortical erosions, periosteal reaction, osteoporosis or other metaphyseal manifestations. Whereas pattern (II) (n=18)(fig -left) appears as generalized diminished bone density with prominent primary and secondary bone trabeculations, widening of the metaphyseal zone with relatively more lucency (loss of all bone trabeculations). Patients with pattern I had significantly higher body mass index and insulin- like growth factor-I (IGF-I) levels compared to those with pattern II (left). Complete healing of the radiological evidence of both patterns was achieved in all patients after one to 2 years of vitamin D therapy.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This work was supported, however funding details unavailable.

Authors have nothing to disclose.