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Year : 2012  |  Volume : 3  |  Issue : 1  |  Page : 39-43

Anemia in Infants with Vitamin D Deficiency Rickets: A Single Center Experience and Literature Review

1 Professor of Pediatrics, Department of Pediatrics, College of Medicine, Taibah University, Saudi Arabia
2 Assistant Professor of Pediatrics, College of Medicine, Taibah University; Consultant hematology/oncology, Medina Maternity & Children's Hospital, Saudi Arabia
3 Consultant hematology/oncology, Medina maternity & Children's Hospital (MMCH), Saudi Arabia

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We sought to elucidate the relationship between vitamin D deficiency rickets and anemia. This hospital-based study enrolled infants with rickets who were seen in a 300-bed children's hospital as outpatients or inpatients. Hematological parameters were studied and all cases were categorized as active or healed, based on radiological evidence. For the purpose of this study, iron-deficiency anemia was defined as hemoglobin (Hb) below 11 g/L and mean corpuscular volume (MCV) below 70. In 95 infants, Hb levels ranged from 5 to 14 g/L and 48% of active rickets cases were considered anemic. Hb levels in active rickets indicated anemia and were significantly lower than in healed subjects (10.48 g/L vs. 11.52 g/L, p = 0.037). MCV was low in the active rickets group. Many recent cases of rickets and anemia were reported as myelofibrosis and responded well to vitamin D and calcium. We conclude that 3 types of anemia are associated with vitamin D deficiency rickets. The most common is iron deficiency anemia due to common nutritional and other factors; the second most common is hemolytic anemia, known as Northern syndrome, that has been reported in Native Americans in Canada. The third is a very rare anemia due to myelofibrosis involving platelets and neutrophils.

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