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Rickets is disorder of a growing child arising from disorders that result in impaired apoptosis of hypertrophic cells and mineralization of the growth plate. Rickets due to nutritional causes remains an important global problem. The factors responsible for resurgence of rickets among dark-skinned infants living in developed countries include the following: residence in northern or southern latitudes, voluntary avoidance of exposure to solar ultraviolet B radiation, maternal vitamin D deficiency during pregnancy, and prolonged breastfeeding without provision of vitamin D supplements. Fibroblast growth factor 23 (FGF23), secreted by osteocytes, is an important regulator of serum phosphate and 1,25(OH)2D3 levels. Hypophosphatemic rickets resulting from increased synthesis or under-catabolism of FGF23 is reviewed.
KeywordsCalcium FGF23 DMP1 Hypophosphatemic ENPP1 PHEX Phosphate Rickets Vitamin D Vitamin D–dependent rickets XLH 25(OH)D 1,25(OH)2D
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