Skip to main content
PMC home page
CMAJ : Canadian Medical Association Journal logoLink to CMAJ : Canadian Medical Association Journal
. 1986 Feb 1;134(3):237–241.

Vitamin-D-deficient rickets in Manitoba, 1972-84.

J C Haworth, L A Dilling
PMCID: PMC1490697  PMID: 3942930

Abstract

Vitamin-D-deficient rickets still exists in children in Manitoba and adjacent areas. Between 1972 and 1984, 48 cases were documented at Winnipeg Children's Hospital. The patients ranged in age from 1 to 49 months; 40 were Canadian natives (38 Indians and 2 Inuit), most of whom lived in the Island Lake area of northern Manitoba. Of the 48, 16 had clinical signs of rickets, 12 had tetany due to hypocalcemia and 38 had radiologic evidence of rickets. Hypocalcemia was found in 27, and hypophosphatemia in 19; hyperaminoaciduria was found in 7 of 20. All 48 had elevated serum alkaline phosphatase levels. In addition to rickets, 16 patients aged 12 months or more had evidence of malnutrition. Climate and lifestyle in northern areas of the Canadian midwest result in little or no biosynthesis of vitamin D by solar radiation; therefore, adequate dietary vitamin D intake is essential to prevent deficiency. The diets of pregnant women and infants in these areas are deficient in vitamin D. The authors recommend vitamin D supplements for all pregnant women and infants in areas of risk to eradicate this preventable disease.

Full text

PDF
237

Images in this article

239Fig. 3
on p.239
239Fig. 4
on p.239

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adamson J. D., Jolliffe N., Kruse H. D., Lowry O. H., Moore P. E., Platt B. S., Sebrell W. H., Tice J. W., Tisdall F. F., Wilder R. M., Zamecnik P. C. Medical Survey of Nutrition in Newfoundland. Can Med Assoc J. 1945 Mar;52(3):227–250. [PMC free article] [PubMed] [Google Scholar]
  2. Arnaud C. D., Tsao H. S., Littledike T. Radioimmunoassay of human parathyroid hormone in serum. J Clin Invest. 1971 Jan;50(1):21–34. doi: 10.1172/JCI106476. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Arnaud S. B., Matthusen M., Gilkinson J. B., Goldsmith R. S. Components of 25-hydroxyvitamin D in serum of young children in upper midwestern United States. Am J Clin Nutr. 1977 Jul;30(7):1082–1086. doi: 10.1093/ajcn/30.7.1082. [DOI] [PubMed] [Google Scholar]
  4. Arnaud S. B., Stickler G. B., Haworth J. C. Serum 25-hydroxyvitamin D in infantile rickets. Pediatrics. 1976 Feb;57(2):221–225. [PubMed] [Google Scholar]
  5. Barsky P. Rickets: Canada: 1968. Can J Public Health. 1969 Jan;60(1):29–31. [PubMed] [Google Scholar]
  6. Bouillon R., Kerkhove P. V., De Moor P. Measurement of 25-hydroxyvitamin D3 in serum. Clin Chem. 1976 Mar;22(3):364–368. [PubMed] [Google Scholar]
  7. Brooks M. H., Bell N. H., Love L., Stern P. H., Orfei E., Queener S. F., Hamstra A. J., DeLuca H. F. Vitamin-D-dependent rickets type II. Resistance of target organs to 1,25-dihydroxyvitamin D. N Engl J Med. 1978 May 4;298(18):996–999. doi: 10.1056/NEJM197805042981804. [DOI] [PubMed] [Google Scholar]
  8. Curtis J. A., Kooh S. W., Fraser D., Greenberg M. L. Nutritional rickets in vegetarian children. Can Med Assoc J. 1983 Jan 15;128(2):150–152. [PMC free article] [PubMed] [Google Scholar]
  9. Dilling L. A., Ellestad-Sayed J., Coodin F. J., Haworth J. C. Growth and nutrition of preschool Indian children in Manitoba: I. Vitamin D deficiency. Can J Public Health. 1978 May-Jun;69(3):248–252. [PubMed] [Google Scholar]
  10. Ellestad-Sayed J. J., Haworth J. C. Disaccharide consumption and malabsorption in Canadian Indians. Am J Clin Nutr. 1977 May;30(5):698–703. doi: 10.1093/ajcn/30.5.698. [DOI] [PubMed] [Google Scholar]
  11. Fraser D. R. The physiological economy of vitamin D. Lancet. 1983 Apr 30;1(8331):969–972. doi: 10.1016/s0140-6736(83)92090-1. [DOI] [PubMed] [Google Scholar]
  12. Fraser D., Kooh S. W., Kind H. P., Holick M. F., Tanaka Y., DeLuca H. F. Pathogenesis of hereditary vitamin-D-dependent rickets. An inborn error of vitamin D metabolism involving defective conversion of 25-hydroxyvitamin D to 1 alpha,25-dihydroxyvitamin D. N Engl J Med. 1973 Oct 18;289(16):817–822. doi: 10.1056/NEJM197310182891601. [DOI] [PubMed] [Google Scholar]
  13. Fraser D., Kooh S. W., Scriver C. R. Hyperparathyroidism as the cause of hyperaminoaciduria and phosphaturia in human vitamin D deficiency. Pediatr Res. 1967 Nov;1(6):425–435. doi: 10.1203/00006450-196711000-00001. [DOI] [PubMed] [Google Scholar]
  14. Gertner J. M., Glassman M. S., Coustan D. R., Goodman D. B. Fetomaternal vitamin D relationships at term. J Pediatr. 1980 Oct;97(4):637–640. doi: 10.1016/s0022-3476(80)80029-1. [DOI] [PubMed] [Google Scholar]
  15. Greer F. R., Ho M., Dodson D., Tsang R. C. Lack of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D in human milk. J Pediatr. 1981 Aug;99(2):233–235. doi: 10.1016/s0022-3476(81)80459-3. [DOI] [PubMed] [Google Scholar]
  16. Haddad J. G., Chyu K. J. Competitive protein-binding radioassay for 25-hydroxycholecalciferol. J Clin Endocrinol Metab. 1971 Dec;33(6):992–995. doi: 10.1210/jcem-33-6-992. [DOI] [PubMed] [Google Scholar]
  17. Heckmatt J. Z., Peacock M., Davies A. E., McMurray J., Isherwood D. M. Plasma 25-hydroxyvitamin D in pregnant Asian women and their babies. Lancet. 1979 Sep 15;2(8142):546–548. doi: 10.1016/s0140-6736(79)91612-x. [DOI] [PubMed] [Google Scholar]
  18. Kao P. C., Jiang N. S., Klee G. G., Purnell D. C. Development and validation of a new radioimmunoassay for parathyrin (PTH). Clin Chem. 1982 Jan;28(1):69–74. [PubMed] [Google Scholar]
  19. Kooh S. W., Fraser D., Reilly B. J., Hamilton J. R., Gall D. G., Bell L. Rickets due to calcium deficiency. N Engl J Med. 1977 Dec 8;297(23):1264–1266. doi: 10.1056/NEJM197712082972307. [DOI] [PubMed] [Google Scholar]
  20. Leerbeck E., Søndergaard H. The total content of vitamin D in human milk and cow's milk. Br J Nutr. 1980 Jul;44(1):7–12. doi: 10.1079/bjn19800004. [DOI] [PubMed] [Google Scholar]
  21. PETT L. B. Signs of malnutrition in Canada. Can Med Assoc J. 1950 Jul;63(1):1–10. [PMC free article] [PubMed] [Google Scholar]
  22. Scriver C. R. Fondements biologiques de la sensibilité du rachitisme à la vitamine D. Union Med Can. 1971 Mar;100(3):462–474. [PubMed] [Google Scholar]

Articles from CMAJ: Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES