Rickets in low birth weight infants receiving total parenteral nutrition

摘要: Abstract Development of rickets in association with parenteral nutrition is described four premature infants having gestational ages 26–31 wk. In the first two there was a documented deficiency vitamin D, but second adequate supplementation achieved. Vitamin whose primary action to facilitate intestinal absorption calcium, may also be hormone prime necessity infant bone formation. Conversion precursor cholecalciferol active form hormone, 1,25-DHCC, requires intermediate hydroxylation by liver. The liver deficient its ability carry out this step metabolism, and normal intrauterine existence fetus receive metabolite, from mother. Calcium intake these far below that achieved fetuses comparable age utero, even though excess provided usual oral formulas. Although calcium has not been incriminated as cause past, it possible very tiny rapid growth requirements lead relative which manifested uncalcified osteoid. Until mechanism formation small clarified recommended supplemental D given all receiving nutrition, periodic x-rays obtained detect development rickets.