Rickets is a childhood disease mainly occuring due to vitamin D deficiency. The bones become weak and soft and are more prone to fracture and deformities.
Osteomalacia is similar condition occuring in adults.
Types of Rickets
• Hypocalcemic Rickets – This occurs due to impaired metabolism of vitamin D and calcium resulting into vitamin D deficiency and Calcium deficiency.
•Hypophosphatemic Rickets – This occurs due to low serum phosphate levels.
Causes
•Vitamin D Deficiency
-decreaed sun exposure
-malabsorption disease
•Chronic liver disease
•Renal tubular disease
•Neonatal hepatitis
•Limited breast feeding
•Improper diet
•Certain medications
•Certain Genetic anomalies
For Pathophysiology Also Refer This link VITAMIN D DEFICIENCY
Genes Related to Rickets-
•The most common form of disease is X-lined hypophosphatemic rickets (XLH).
•It is an autosomal form of disease.
•XLH rickets occur due to inactiving mutations in PHEX gene.
•PHEX(Phosphate regulating neutral endopeptidase) gene is expressed in bones , teeth and in mineralization and renal phosphate reabsorption.
•PHEX is involved in suppressing the response of FGF23
•FGF23(Fibroblast growth factor 23) gene signals the kidney to stop reabsorption of phosphate in to bloodstream.
•PHEX mutations lowers the tubular reabsorption of phosphate and vit D.
This contribute to bone diseases.
Signs and Symptoms –
•Muscle weakness
•Bone tenderness and retarded growth
•Delayed closure of anterior frontalle
•Delayed eruption of teeth and enamel defect
•Enlargement of long bones
•Anterior curving of legs,bow legs
•Green stick fracture
•Seizures and tetany
•Improper gait, bone pain
Diagnosis –
•Blood tests – Serum calcium and serum phosphate show low level along with changes in shape and structure of bone’s.
•Bone biopsy for confirmation.
Homoeopathic Medicine for Rickets-
•Thyroidinum – Thyroid producing anaemia, muscular weakness, nervous tremor, rheumatoid arthritis. Infantile wasting rickets. Delayed union of bones, nocturnal enuresis. Oedema of legs.
•Phosphorus – Dullnes of head, obstinate vertigo. Caries in teeth, drawing and tearing toothache, bleeding and grinding of teeth, gums separated from teeth. Weakness in all limbs, swelling of hand and feets, joint stiff.
•Calcaria Phosphorica – Wewakness of bones,large open frontalle, headache, skull soft. Slow dentition, tearing boring pain in gums, fever during dentition,pain in molars. Rheumatic pain in shoulder and arms, paralysis of joints.
•Baryta Carbonica – Suited to old people, dwarfs, scrofulous children inclined to grow fat. Glandular swelling. Chronic enlargement of tonsils. Abdomen distended and hard.
•Thuja occidentalis – Scalp sensitive to touch and painful, weakness in head. Caries of teeth, crown of teeth remains sound, gums swollen. Trembling of hands and feets, cracking of joints, frozen limbs.
•Silicea terra – Stiffness of nape,caries of clavicle, swelling of gland in nape,coccyx painful, tearing and shooting pain in back.Weakness of joints,cramps of arms and legs,jerk in limbs.
•Kalium Iodatum – Glands swollen or atrophied. Gouty daithesis. Swelling of bones, contraction of muscles and tendons, pain after long injury.its is also very well indicated in Dropsy accompanying Rickets basically due to renal complaints impairing calcium resoption.
Conservative management for Rickets-
- Exposure to Ultraviolet B rays
- Increasing dietary intake of calcium
- Phosphate and vitamin D
- Cod liver oil
- Halibut liver oil
- Vit D fortified milk
- Vit D supplements