Extremely premature infants may develop infantile rickets which hopefully will reverse with maturation.
Pathogenesis - multifactorial, including:
(1) dietary deficiency in calcium and/or phosphate
(2) immaturity in the intestinal vitamin D receptors, resulting in poor absorption
(3) gastrointestinal disease with malabsorption (intestinal rickets)
Patient selection: very premature infant
Clinical findings
(1) osteopenia
(2) pathologic fractures
Laboratory findings:
(1) low serum calcium concentration
(2) low serum phosphate concentration
(3) high serum parathyroid hormone (PTH) level
(4) high serum 1,25-dihydroxy vitamin D
Management:
(1) oral supplementation in calcium and phosphate
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Specialty: Surgery, orthopedic
