No matter how sad it may be, but in the modern world there are many different childhood diseases. Rickets is a disease that is associated with a slowdown and disruption of the normal development of children. It greatly affects the life of the child, as a result of which it is with great difficulty that even elementary actions are given to him. The pathogenesis of rickets in children (briefly information about this disease will be discussed later) is due to a violation of metabolic processes in the body, as a result of which bone and muscle tissues do not receive enough vitamins, trace elements and nutrients, which significantly slows down and completely stops their formation and development. The disease can manifest itself not only in the musculoskeletal system, noticeable deviations are observed in the functioning of internal organs and the central nervous system. In most cases, rickets occurs in early childhood, and clinical symptoms, as a rule, make themselves felt already in the first months of life.
Reasons for the development of the disease
Rickets (pathogenesis will be briefly discussed in the text) develops in children as a result of insufficient exposure to ultraviolet radiation, which contributes to the production of vitamin D in the body. It is he who is responsible for the normal absorption of calcium obtained in food from various foods. It is important to understand that this reason is the main one, but not the only one. The main prerequisite for the appearance of rickets is a deficiency of vitamins A, B and E, as well as ascorbic acid - one of the main components involved in the formation of bone tissue.
The pathogenesis of rickets (the causes of the disease can be very diverse) is also closely related to the lack of elements such as:
- calcium;
- iron;
- magnesium;
- copper;
- cob alt;
- zinc and many others.
Thus, it can be summarized that a bone formation disorder occurs as a result of a lack of nutrients necessary for the normal development of the body.
Predisposition to the disease and the main risk group
Let's take a closer look at this. The pathogenesis of rickets is associated not only with a deficiency of vitamins and minerals. Many factors influence the development of the disease. At risk are children who receive inadequate and poor nutrition.
Predisposition to rickets is also explained by the following reasons:
- in the first year of life, children actively developskeletal system, so they need large amounts of vitamin D;
- difficult pregnancy;
- various chronic diseases in the mother;
- overfeeding baby;
- feeding cow's milk and infant formula;
- infectious diseases;
- impaired intestinal absorption;
- rare outdoor walks;
- low baby mobility;
- long-term use of various medications.
Rickets in children (etiology, pathogenesis were discussed earlier) most often develops if the babies were born before the expected date. This is due to the fact that in their body there is a smaller supply of vitamins and nutrients, the bone tissue is not sufficiently compacted, the protective functions of the body are low, and the digestive system is poorly developed, as a result of which it is not able to absorb nutrients normally.
Mechanism of origin and development of the disease
So what is he like? The pathogenesis of rickets in children is a very complex process that has many features. If the gestation and childbirth took place without any complications, then the newborn's thyroid glands, which are responsible for the production of the hormone necessary for the absorption of calcium and phosphorus, as well as metabolic processes, function and proceed normally. Under the influence of solar radiation, biological and chemical processes are activated in the skin, as a result of which vitamin D is synthesized, due to which bone tissuenormally absorbs phosphorus and calcium.
With an insufficient amount of vitamins in the body of a child, the intestines are not able to absorb calcium normally, as a result of which its level in the blood is greatly reduced. To compensate for the deficiency of this element, the body begins to draw it out of the bone tissue.
Thus, the pathogenesis of rickets is often associated with the development of osteoporosis, in which the following occurs:
- bone becomes softer and more fragile;
- skeleton begins to deform;
- cartilage ossification occurs;
- excess formation of non-calcified osteoid tissue.
In addition to all of the above, the child also has a violation of the protein, carbohydrate and fat metabolism.
Clinical manifestations
What are they? So, we examined what the pathogenesis of rickets is. Symptoms of the disease in this case can be different and depend on its severity and stage.
The course of the disease is divided into the following periods:
- initial;
- progressive;
- final;
- recurrent.
To understand how the disease develops and proceeds, as well as what clinical manifestations are observed in this case, let's take a closer look at each of them.
Initial Period
The pathogenesis of rickets in children (briefly about what constitutes an ailment was described earlier) at the initial stage of development manifests itself at 2-3 months of a baby's life. The duration of this period is usuallyis from 14 to 28 days. In most cases, manifestations are associated with abnormalities in the functioning of the central nervous system. Behavioral factors change in the child, and frequent mood changes are also observed. He behaves more restlessly and irritably, is constantly naughty, and does not sleep well.
Sweating increases due to ANS dysfunction in children. This is especially noticeable during sleep and feeding. At the same time, sweating is accompanied by an unpleasant sour smell, and the baby's body becomes sticky. The skin may become irritated. In the back of the head, hair begins to fall out and a so-called venous pattern is formed, which is clearly visible. When visually examining the baby's head, you can notice a slight softening of the non-ossified areas and sutures of the skull.
The pathogenesis of rickets in children at the initial stage of the development of the disease can also be detected by excretion of waste products. The chair becomes unstable, and the smell of urine gives off ammonia. As for the chemical composition of the blood, the level of calcium is within the normal range, but the content of phosphorus is somewhat reduced.
It is worth noting that at the initial stage, rickets is treatable, so when the first symptoms of the disease appear, you should immediately contact a pediatrician. If treatment is not started on time, the disease will become more severe.
Progressive period
The pathogenesis of rickets at this stage is pronounced. Significant changes occur in the child's bodybone skeleton and muscle tissue, as well as violations in the work of internal organs. Softened areas appear on the skull, the nape area becomes flat, and the shape of the head may change. Bumps often form on the forehead and crown, and the bridge of the nose looks sunken. In some cases, the baby's eyeballs are displaced, as a result of which vision may deteriorate.
Calcium deficiency in bone formation disorders leads to a slower eruption of milk teeth and a change in their order. Thickenings appear on the ribs between the bone and cartilage tissue, and the chest is deformed and begins to bulge forward a little. Thickening also appears on the fingers, lower legs and wrists at 6-8 months of life.
The lower limbs change their shape, as a result of which a narrowed pelvis is formed in girls in the future. At the same time, the ligamentous apparatus and muscles develop very weakly, so the so-called “frog” belly appears in children, and the joints become loose. Changes in the shape of the chest disrupt the respiratory system, which is accompanied by severe shortness of breath. Very often, children develop pneumonia of viral etiology. In addition, the heart shifts to the right, resulting in an increased heart rate and lower blood pressure.
Rickets (etiology and pathogenesis may be different) in the progressive stage is very often accompanied by the following clinical changes and concomitant diseases, such as:
- anemia;
- increase in the size of internal organs;
- violation of wave-like contractions of the large intestine;
- loss of appetite;
- unstable stool.
If there is no proper treatment for rickets for a long period of time, then due to a deficiency of calcium and phosphorus in the blood, spasmophilia develops in children.
Final Period
The pathogenesis of rickets in the period of convalescence is accompanied by reverse symptoms. Pronounced clinical manifestations in most cases disappear before the content of calcium and phosphorus in the blood normalizes, and the child's well-being improves. At the same time, the biochemical composition of the blood is slightly deviated from the norm, since calcium is intensively supplied to the bone tissue.
Recurrent period
Rickets may continue to make itself felt after completing a course of therapy for the first 2-4 years of a baby's life. Depending on the individual characteristics of the organism, these periods may be longer. The progression of the disease stops, however, for a long period of time, the size of the internal organs remains enlarged. In some cases, deformation of the limbs, skull and chest remains in children for life, however, fortunately, this happens extremely rarely and is more the exception than the rule.
Diagnosis of disease
You already have a detailed idea of how the pathogenesis of rickets manifests itself. Diagnosis of the disease includes a set of studies that allow you to accurately determine and confirm the presence of a bone formation disorder in a baby. For this childa biochemical blood test is prescribed, aimed at studying its composition. Doctors are interested in readings of the content of calcium, phosphorus and enzymes of a certain group. In addition, a general examination of patients is carried out. Based on the clinical picture of the patient, an accurate diagnosis is made and a treatment program is selected.
Treatment of disease
Depending on the stage of the course of the disease, the pathogenesis of rickets also changes. In this case, treatment is selected on an individual basis, depending on the complexity of the course of the disease and its period. In most cases, therapy is based on the use of medications that contain vitamin D. At the same time, doctors recommend paying great attention to the nutrition of children. For them, a special balanced diet is selected. It is also recommended to spend as much time as possible with the baby in the fresh air, perform therapeutic gymnastic exercises, conduct ultraviolet irradiation, do a special massage, and also take s alt, coniferous and sun baths. In addition, vitamin therapy and a number of measures aimed at strengthening the body are prescribed. If the patient has an acute calcium deficiency, then drugs containing a large amount of this element are prescribed, as well as normalizing the absorption capacity of the intestine.
As medical statistics show, in most cases, treatment proceeds normally and allows you to completely defeat the disease if therapy was started at its initial stage. At a later date in the child's bodythere are irreversible changes that, unfortunately, remain for life.
How to prevent the development of the disease?
This issue should be given special attention. Any disease is much easier to prevent than to subsequently cure. By following certain tips and tricks, you can greatly reduce your chances of developing a bone formation disorder. Prevention of rickets (the pathogenesis of the disease was discussed earlier) should be carried out both at the stage of gestation and during the first months of a baby's life. The main part of the activities concerns breastfeeding.
They mean the following:
- Do not use artificial formula to feed your baby. Breast milk is the best source of vitamins, minerals and nutrients.
- If for some reason breastfeeding is not possible, take formula very seriously.
- From the first days of a child's life, do a special firming massage.
- To strengthen the body and improve its protective functions, perform douches and rubdowns.
- Sunlight is the best source of vitamin D, so make sure you spend as much time outdoors as you can every day.
- Give your child a solution of "Akvodetrim". This formulation contains a large amount of vitamin D, so it will provide the baby with the necessary daily dose of the steroid prohormone.
Despite the fact that rickets is not fatal, nevertheless it is verya serious illness that can ruin a child's life. Therefore, try to adhere to the tips listed above in order to minimize the likelihood of developing this disease in your baby. At the first symptoms of any problems, immediately seek help from a qualified doctor.
