Question
The child is 29 months old, weighs 33 pounds, and is 98 centimeters tall. Since birth, the child has been deficient in vitamin D. They have tried 400 units, 800 units, and calcitriol. The bone phosphatase test still shows a significant deficiency. The child now has symptoms of ribcage deformity and pectus excavatum.
Answer
If a child over 2 years old shows persistent rickets symptoms, it is necessary to consider conditions such as hypophosphatemic vitamin D-resistant rickets, distal renal tubular acidosis, vitamin D-dependent rickets, and renal rickets. It is recommended to consult a regular hospital for a detailed examination to determine if any of these causes are present.