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Master Thesis

Rachitisme carentiel de l’enfant en France : une étude épidémiologique multicentrique, aspects diagnostiques et thérapeutiques

Abstract : Introduction: Nutritional rickets is rare in children but its incidence has increased for years. The aim of this study is to describe the risk factors, the clinical, biochemical and radiological signs of it, and its treatments, in a French children cohort. Patients and methods: Patients included were younger than 16 years of age and had a diagnosis of nutritional rickets. A total of 39 children were included. Results: 39 children (11 females and 28 males) are included. Most of them were non-Caucasian. The median age at diagnosis was 23 months. The vitamin D prophylaxis was unadequate for 77% of them. At diagnosis, children presented a serum 25(OH)D low (Median 6,5 ng/ml 2-42), increased ALP (Median: 971UI/L 213-7382) and PTH (Median: 243 mmol/L 14-1317). The serum calcium level was below or equal to 1,8 mmol/L in 13 children (54% had severe symptoms). The most frequent clinical sign at diagnosis was bone deformations (61,5%) especially genu varum. Generalized hypocalcemic seizures was found in 18%. The median height was -0,89 DS. The most frequent clinical sign of rickets was epiphyseal swelling. Two children had a dilated cardiomyopathy. The rickets healed upon treatment with vitamin D for all the patients. Conclusion: It is important to prevent nutritional rickets especially in infants and teenagers, and population resulting from immigration. The main risk factor seems to be the lack of vitamin D prophylaxis.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02419598
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Submitted on : Thursday, December 19, 2019 - 3:35:45 PM
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Claire Flot. Rachitisme carentiel de l’enfant en France : une étude épidémiologique multicentrique, aspects diagnostiques et thérapeutiques. Médecine humaine et pathologie. 2019. ⟨dumas-02419598⟩

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