Semptomatik Hipokalsemi ve Nütrisyonel Rikets Nedenli Hastane Başvuruları: Göçmen Suriye’li Süt Çocuklarının Predominansı

Objective: Nutritional rickets is a disorder of defective mineralization of growth plate in growing children due to vitamin D and calcium deficiency. In our country, vitamin D is routinely used during infancy to prevent nutritional rickets. However, it is noteworthy that there are still hospital admissions due to symptomatic hypocalcemia and vitamin D deficiency. Our study aimed to reveal the features of these cases. Material and Method: Data of 28 patients (9 girls, 19 boys) hospitalized due to nutritional rickets between January 2018 and May 2018 were analyzed retrospectively. Anthropometric and laboratory features of the patients were recorded. Results: The median age of admission was 8.8 (1-35) months. Most of the patients (67.9%) were immigrants from Syria. 57.1% of patients didn’t receive any vitamin D prophylaxis, while 42.9% received irregularly. Majority of patients (50%) were admitted due to convulsion, while 28.6% with signs of rickets and 21.4% with incidental hypocalcemia. At the time of admission, median calcium was 6.6 mg/dL; ionized calcium 0.85 mmol/L; phosphorus 3.5 mg/dL; alkaline phosphatase 787 U/L; parathormone 241 pg/mL and 25-hydroxyvitamin D was 3.4 ng/mL. Hypophosphatemia was detected in 60.7% of the patients, while 3.6% had hyperphosphatemia. All patients were hospitalized and diagnosed as nutritional rickets due to vitamin D deficiency. Conclusion: Despite vitamin D prophylaxis in our country, nutritional rickets can still be seen and lead to hospital admission due to hypocalcemic convulsions in winter and spring. Increasing the compliance with vitamin D support program especially for immigrant Syrian infants is essential for the prevention of nutritional rickets.