Abstract
Rickets, often leading to fractures and bone deformities, occurs in children with cholestatic liver disease (CLD) because of decreased intestinal absorption of minerals and impaired hepatic hydroxylation of vitamin D. The purpose of our investigation was to determine the frequency of rickets and its response to 1,25 (OH)2 vitamin D therapy in 18 children with CLD, ages 2 months to 5 years, over a two-year period. Serial measurements of bone mineral content were obtained using photon absorptiometry of the wrist and serum values of 25-OH vitamin D and bilirubin measured on CLD patients receiving 400-1200 IU vitamin D by mouth. In 3 of 18 children bone mineral content (BMC) was normal for age. All had direct serum bilirubin <2.0 mg/dl and normal serum 25-OH D (N=10-40 ng/ml). In 15 of 18 children BMC was >2 SD below the mean BMC of normal age-matched controls; serum 25-OH vitamin D was also low (<10 ng/ml). Once rickets was diagnosed, 12 patients received .05 to .1 ug/kg/day 1,25 (OH)2 vitamin D. Eight of 12 children treated with 1,25 (OH)2 vitamin D had improvement of bone disease indicated by a doubling of the BMC and an increase in the BMC/body-weight ratio to the normal range. Conclusion: Metabolic bone disease is common in children with CLD. Photon absorptiometry is a simple and accurate technique for identifying and monitoring children with hepatic rickets. In children with CLD oral 1,25 (OH)2 vitamin D may be effective for the treatment of hepatic rickets.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Roberts, C., Book, L., Chan, G. et al. 625 RICKETS IN CHILDREN WITH CHOLESTATIC LIVER DISEASE: EVALUATION AND TREATMENT. Pediatr Res 15 (Suppl 4), 544 (1981). https://doi.org/10.1203/00006450-198104001-00638
Issue Date:
DOI: https://doi.org/10.1203/00006450-198104001-00638
This article is cited by
-
Treatment options for chronic cholestasis in infancy and childhood
Current Treatment Options in Gastroenterology (2005)