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Old 09-08-2012
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Arrow Gyrus Daily Questions; Pediatrics #29

A 2 years child with vit D resistent rickets was evaluated. His lab investigation reveal.
  • Serum calcium - 9 mg/dl
  • Serum phosphate - 2.4 mg/dl.
  • Serum alkaline phosphate - 1041 IU
  • Parathormone level - 59 units.
The likely diagnosis is:

a. Distal renal tubular acidosis.
b. Vit D dependent rickets.
c. Hypophophatemic rickets.
d. Hyperparathyroidism
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Old 09-08-2012
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I think C, phosphorus is low
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c. Hypophophatemic rickets.

But according to UW (QID: 3491) the Serum alkaline phosphate is normal in Hypophophatemic rickets. In the vignette it is high.

According to medscape the Serum alkaline phosphate is raised in Vit D deficient rickets which is not among the choices here.
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Old 09-09-2012
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Answer is C Hypophosphatemic rickets...

Gyrus Daily Questions; Pediatrics #29-ricket-table.jpg
Click image to enlarge

Ref Nel Nelson 19ed p202
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Old 09-09-2012
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Quote:
Originally Posted by Novobiocin View Post
c. Hypophophatemic rickets.

But according to UW (QID: 3491) the Serum alkaline phosphate is normal in Hypophophatemic rickets. In the vignette it is high.

According to medscape the Serum alkaline phosphate is raised in Vit D deficient rickets which is not among the choices here.
Sorry i couldn't refer the question u mentioned...But as far as i know...In allcases of rickets Alkalinephosphate will be elevated... except one condition

Hypophosphatasia ...Nelson p 2447
Autosomal rescessive conditon with low poduction of alkalline phosphate.
Clinical features of rickets..
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