Article Text

Download PDFPDF
Supplementation in hypophosphataemic rickets: the bare bones of management
  1. Iona Natasha Mary Liddicoat1,
  2. Mark Peter Tighe2
    1. 1 Paediatric Research, Poole Hospital NHS Foundation Trust, Poole, UK
    2. 2 Paediatrics, Poole Hospital NHS Trust, Poole, UK
    1. Correspondence to Dr Iona Natasha Mary Liddicoat, Paediatric Research, Poole Hospital NHS Foundation Trust, Poole BH15 2JB, UK; ionaliddicoat{at}gmail.com

    Statistics from Altmetric.com

    A female patient, born at 25 weeks’ gestation, had developed cerebral palsy, microcephaly, cystic periventricular leukomalacia, developmental delay and epilepsy. At 3 weeks, she had a significant bowel resection for necrotising enterocolitis, with 65 cm of small bowel remaining. She required total parenteral nutrition for several weeks. During her long recovery in neonatal intensive care, she developed feeding difficulties, diarrhoea and prolonged vomiting when the parenteral nutrition was weaned. She now has an unsafe swallow, severe reflux and is gastrojejunally fed, with exclusive elemental feed (Neocate). Of note, her medication currently includes Abidec®, cholecalciferol, clobazam and omeprazole.

    At 16 months of age, she presented to the children’s unit with a large bruise following venepuncture. Humeral X-ray showed a fracture over the bruise site, and further skeletal survey (figures 1–3) showed widespread rachitic changes. Relevant bloods are shown in table 1.

    Figure 1

    Anteroposterior (AP) X-ray right foot: first, third, fourth and fifth right metacarpal fractures.

    Figure 2

    X-ray right tibia with proximal tibial and fibular fractures. …

    View Full Text

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.