Rickets in the tropics: not always nutritional.

### Vitamin D-dependent rickets type I A 6-year-old girl belonging to the lower socioeconomic class of a Muslim community, product of consanguineous marriage presented in the paediatric outpatient department with a history of progressive bowing of limbs, recurrent chest infections requiring hospitalisations in the past and failure to thrive. Calorie and protein consumption was just one-third of the requirement. Family history of similar problems was present in the mother. The mother had frank rickets beginning at the age of 1 and progressively increasing with age. The mother was treated at a private clinic for her disease with 1,25-dihydroxycholecalciferol (Calcitriol). A clinical examination revealed florid manifestations of rickets (figure1 A–D). Investigations showed near normal 25-hydroxy vitamin D and a low concentration of 1,25-dihydroxyvitamin D …