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Vitamin D deficiency – bone health — RACP Paediatrics MCQ

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EasyEndocrineVitamin D deficiency – bone healthRACP Paediatrics

A 2-year-old who has been exclusively breastfed is found to have low bone mineral density on DEXA performed for concern about bowed legs. 25-hydroxyvitamin D is <10 nmol/L. PTH is elevated. What is the most important initial treatment?

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Correct answer: E — Vitamin D supplementation

Vitamin D deficiency is the most common correctable cause of low BMD in young children. High-dose vitamin D supplementation (stoss or daily therapy) will correct the deficiency, normalise PTH, and improve bone mineralisation. Calcium supplementation may also be needed. The underlying rickets should be treated concurrently.

Reference: RCH Melbourne – 2023 – Rickets CPG; RACP Paediatric Curriculum – Endocrine