VITAMIN-D DEFICIENCY RICKETS IN RIYADH

Despite the fact that much of Saudi Arabia is sunny throughout most of the year, vitamin D deficiency rickets is not rare. Different factors are responsible for this phenomenon, especially nutritional, social, and maternal vitamin D deficiency. We identified 500 cases of rickets out of a total of 27,236 hospital admissions, and followed at Suleimania Children's Hospital in Riyadh over three years (1986 to 1988). Eighty-one percent of the patients were Saudi (mean age, 8.2 months), which is significantly lower than that usually observed. Most of the patients had nonspecific findings at onset, indirectly related to the vitamin D deficiency, particularly recurrent chest infections (66%) and hypocalcemic convulsions (17.2%). The young age at onset, which was 39.2% in patients younger than six months at onset and 14.2% in those younger than three months, is unusual compared with ages cited in the literature, and this most probably relates to maternal vitamin D deficiency. Subclinical forms of rickets, detected by the screening, also seem to be common. We conclude that rickets is a major health problem in Saudi Arabia and more attention needs to be paid to its detection, treatment, and prevention.