佝偻病（英文课件）

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1、RicketsofVitaminDDeficiencyTheSecondAffiliatedHospitalofShantouUniversityMedicalCollegeMaLianReviewRickets：signifyingafailureininernalizationofgrowingboneorosteoidtissue.Failureofmaturebonetomineralizeiscalledosteomalacia.EtiologyInadequatedirectexposuretoultrav

2、ioletraysinsunlightInadequateintakeofvitD(dietmaycontainlittlevitD)GrowthdrugDisease:hepaticandrenallesions、celiacdisease、steatorrheaorcysticfibrosisOrbothAboutVitamin-DTwoforms:vitD2/vitD3vitD2:mostasirradiatedergosterol,largelyreplacedthefishliveroilsassourcevi

3、tD3:availableinhumanskinas7-dehydrocholesterol.botharehydroxylatedintheliverto25－(OH)2Dintherenalto1.25－(OH)2D:facilitatecalciumandphosphorusabsorptedPathologytheepiphysealplateofmetaphysisiswelldemonstrated.ThecartilagecellisorderlyThecalcifiedmatrixformstheepip

4、hysealplateisregularThedegeneratingcartilage,islandsofcapillaries,osteoblasts,andunmineralizedosteoidcomposeofbroad,irregular,rachiticimtermediatezoneChemicalpathologycanbeconceptualizedtobethebody’sattempttomaintainnormalserumcalciumlevels.Whencalciumislesspara

5、thormoneissecretedincreasethecalciumandphosphorusconcentrationAlkalinephosphatase(ALP).(normallevel≦200IU/dL)canbe500UI/dL.Butmaybenormalininfantswhohavericketsandwhoareproteinorzincdepleted.aminoaciduria,adecreaseofcitrate,anditsincreasedurinaryexcretion,decrea

6、sedabilityofthekidneystomakeanacidurine,phosphaturia,andoccasionally,mellituria.TheparathyroidglandshypertrophyClinicalmanifestationsEarlysigns:Increasedsweating,particularlyaroundthehead,whichresultintheoccipitalbonebareClinicalmanifestationsAdvancedrickets:Head

7、:earlysignsiscraniotabes,Likeaderbyhatorpingpongball.Thorax:rachiticrosaryHarrison’sgroovePigenbreastdeformitychildrenarelateinstandingandwalkingThedeformitiesofthelongbones:knobbingandprominenceoftheepiphysesOthermanifestations:Teeth-eruptingmaybedelayed,theenam

8、elandextensiveariesaredefected.MuscletoneispoorRoentgenographicfindingsDiagnosisThediagnosisisbasedon:ahistoryofinadeuateintakeofvitaminDandonclinicalobservati