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Worldwide, rickets is the most common form of metabolic bone disease in children. Vitamin D deficiency is the main cause of rickets, though nutritional deficiency of calcium and phosphorous generates the same clinical picture.
Many cases are due to poor vitamin D intake or calcium deficient diets and can be corrected by administration of calcium and vitamin D. However, some cases are refractory to vitamin D therapy and are related to renal defects. These include rickets of Renal Tubular Acidosis (RTA), Hypophosphatemic rickets, and Vitamin D Dependent Rickets (VDDR). The latter is due to impaired action of 1α-hydroxylase in renal tubule. These varieties need proper diagnosis and specific treatment.
Patient presented in our institution was bed ridden with renal rickets having very severe deformities. Many cases like this disease and its variants begin in childhood and awareness of the conditions may help to bring patients to treatment earlier& decrease the morbidity.