Abstract 720

Introduction: Although nutritional or Vitamin D deficiency rickets is not considered a significant medical problem in the southern United States, 3 infants were admitted to our institution in the spring of 1998 with hypocalcemic seizures secondary to Vitamin D deficiency. We retrospectively reviewed medical records from 1994 to 1998 to determine if a population at high risk for nutritional Vitamin D deficiency exists in southeastern Virginia.

Results: Thirty-three charts of children referred for evaluation of rickets were reviewed. Ten patients were excluded because of rickets of prematurity, lack of radiologic evidence of rickets, or diagnosis of X-linked hypophosphatemic rickets. In addition a 14 year old with nutritional rickets was excluded because of age. Mean age was 12 ± 7 months for the study group. All 22 were of African-American descent. Due to religious beliefs, 3 mothers wore attire preventing sun exposure. Eighteen infants were breastfed without formula supplementation up to presentation. None received Vitamin D supplementation before rickets was suspected; however, two received vitamin supplementation before laboratory data were obtained. The most common physical finding was splaying of the wrists and ankles. with nine having a palpable rachitic rosary. Eighteen infants had radiographic evidence of active rickets and two had healing rickets. Laboratory findings were: (Table)

Table 1 No caption available
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Summary: Twenty-two infants presented with physical, radiologic and laboratory data diagnostic for nutritional rickets; five presented with hypocalcemic seizures,one with tetany. All 22 were African-American, 18 were breastfed and none received vitamin supplementation before diagnosis.

Conclusion: In southeastern Virginia we found that African-American breastfed infants are at risk for nutritional, Vitamin D deficiency rickets. Based on 1990 census data for Hampton Roads, we estimate a potential annual at risk population of 10,000 infants. We conclude that this group would benefit from Vitamin D supplementation.