《儿科学》维生素D缺乏性佝偻病（英文）-教学课件（非AI生成）.ppt

RicketsofVitaminDDeficiency1

ReviewRickets：signifyingafailureininernalizationofgrowingboneorosteoidtissue.Failureofmaturebonetomineralizeiscalledosteomalacia.2

EtiologyInadequatedirectexposuretoultravioletraysinsunlightInadequateintakeofvitD(dietmaycontainlittlevitD)GrowthdrugDisease:hepaticandrenallesions、celiacdisease、steatorrheaorcysticfibrosisOrboth3

AboutVitamin-DTwoforms:vitD2/vitD3vitD2:mostasirradiatedergosterol,largelyreplacedthefishliveroilsassourcevitD3:availableinhumanskinas7-dehydrocholesterol.botharehydroxylatedintheliverto25－(OH)2Dintherenalto1.25－(OH)2D:facilitatecalciumandphosphorusabsorpted4

Pathologytheepiphysealplateofmetaphysisiswelldemonstrated.ThecartilagecellisorderlyThecalcifiedmatrixformstheepiphysealplateisregular5

Thedegeneratingcartilage,islandsofcapillaries,osteoblasts,andunmineralizedosteoidcomposeofbroad,irregular,rachiticimtermediatezone6

Chemicalpathologycanbeconceptualizedtobethebody’sattempttomaintainnormalserumcalciumlevels.Whencalciumisless?parathormoneissecreted?increasethecalciumandphosphorusconcentration7

ChemicalpathologyAlkalinephosphatase(ALP).(normallevel≦200IU/dL)canbe500UI/dL.Butmaybenormalininfantswhohavericketsandwhoareproteinorzincdepleted.8

Chemicalpathologyaminoaciduria,adecreaseofcitrate,anditsincreasedurinaryexcretion,decreasedabilityofthekidneystomakeanacidurine,phosphaturia,andoccasionally,mellituria.Theparathyroidglandshypertrophy9

ClinicalmanifestationsEarlysigns:Increasedsweating,particularlyaroundthehead,whichresultintheoccipitalbonebare10

ClinicalmanifestationsAdvancedrickets:Head:earlysignsiscraniotabes,Likeaderbyhatorpingpongball（time）.11

Thorax:rachiticrosaryHarrison’sgroovePigenbreastdeformitychildrenarelateinstandingandwalking12

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