Rickets is a softening of bones in children potentially leading to fractures and deformity. Rickets is among the most frequent childhood diseases in many developing countries.
The predominant cause is a vitamin D deficiency, but lack of adequate calcium in the diet may also lead to rickets (cases of severe diarrhea and vomiting may be the cause of the deficiency). Although it can occur in adults, the majority of cases occur in children suffering from severe malnutrition, usually resulting from famine or starvation during the early stages of childhood.
Osteomalacia is the term used to describe a similar condition occurring in adults, generally due to a deficiency of vitamin D. The origin of the word "rickets" is probably from the Old English dialect word 'wrickken', to twist. The Greek derived word "rachitis" (ραχίτις, meaning "inflammation of the spine") was later adopted as the scientific term for rickets, due chiefly to the words' similarity in sound.
Those at higher risk for developing rickets include:
- Breast-fed infants whose mothers are not exposed to sunlight
- Breast-fed infants who are not exposed to sunlight
- Babies with dark complexions (e.g. black, South African), particularly when breastfed and exposed to little sunlight
- Individuals not consuming milk, such as those who are lactose intolerant
Individuals with red hair have been speculated to have a decreased risk for rickets due to their greater production of vitamin D in sunlight.
Children ages 6 months to 24 months are at highest risk, because their bones are rapidly growing. Long-term consequences include permanent bends or disfiguration of the long bones, and a curved back.
Vitamin D is required for proper calcium absorption from the gut. Sunlight, especially ultraviolet light, lets human skin cells convert Vitamin D from an inactive to active state. In the absence of vitamin D, dietary calcium is not properly absorbed, resulting in hypocalcemia, leading to skeletal and dental deformities and neuromuscular symptoms, e.g. hyperexcitability. Foods that contain vitamin D include butter, eggs, fish liver oils, margarine, fortified milk and juice, and oily fishes such as tuna, herring, and salmon.
A rare X-linked dominant form exists called Vitamin D resistant rickets.
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