10-Year case review of nutritional rickets in Children's Hospital of Michigan

Nutritional rickets has been on the rise in the United States. A chart review of patients with nutritional rickets from April 1995 to May 2005 was performed. Fifty-eight subjects were studied (62% males, 38% females, with an age range between 2 and 132 months). Of the subjects, 81% were African Americans and 14% were Arabic; 33% were Christians and 19% were Muslims. An increasing number of cases of nutritional rickets have been noted since 2000. Seventy-nine percent of patients with nutritional rickets presented at the emergency department, and in 69% of the cases, rickets was an incidental finding; 96% of patients were exclusively breast-fed, and none received multivitamin supplements. 25-OH vitamin D levels were below 5 ng/mL in 42% of the patients, all of whom were African Americans. We could document complete resolution of nutritional rickets in only 8 patients, and 3 of these patients showed sequelae of rickets.