Failure to Thrive in an 18-Month-Old Female Infant with Rickets: A Case Report

Abstract : Undetected vitamin D deficiency can lead to severe complications such as Rickets in infants. This case report describes an unusual case of an 18-month-old female infant who presented with failure to thrive early in infancy and was later diagnosed with Rickets. The infant initially presented with failure to thrive, labs were ordered, and findings demonstrated low 25-hydroxyvitamin D and elevated alkaline phosphatase. Radiographic imaging of the knee was ordered and showed transverse sclerotic metaphyseal bands involving the distal femoral metaphysis and portion of the proximal tibial metaphysis, findings consistent with untreated rickets. A thorough investigation was conducted to determine the primary cause of the vitamin D deficiency, identifying the primary cause as nutritional deficiency. Per endocrinology, the patient was started on cholecalciferol 800 IU daily with dietary changes. This case emphasizes the importance of checking vitamin D levels in all pediatric patients who present with failure to thrive.