A retrospective study of the biochemical and radiological profile of children with genetic hypophosphatemic rickets and their response to conventional treatment

dc.contributor.authorIsaac, Nikhila
dc.contributor.supervisorThandrayen, Kebashni
dc.date.accessioned2025-03-29T01:41:07Z
dc.date.issued2023-11
dc.departmentPaediatrics
dc.descriptionResearch report submitted in partial fulfillment for the degree of Masters of Medicine in Paediatrics, to the Faculty of Health Science, School of Clinical Medicine, at the University of the Witwatersrand, Johannesburg, 2023.
dc.description.abstractObjectives: Assessing the biochemical and radiological profile of children with genetic hypophosphatemic rickets and their response to conventional treatment. Design: Retrospective descriptive study. Setting: Metabolic Bone clinic at Chris Hani Baragwanath Academic Hospital in Soweto, South Africa. Subjects: Children less than 18 years, attending the Metabolic Bone clinic from 1st January 2006 to April 2020, with genetic hypophosphatemic rickets, commenced on conventional treatment. Results: Seventy patients met the inclusion criteria. Majority of patients were black South African (n=54 (77%)). Positive family history seen in 32 (46%) patients. The patients were short statured with a mean height for age z score (HAZ) of - 3.4 ± 1.79. The mean calcium, phosphate, alkaline phosphatase, parathyroid hormone levels and median Thacher score was 2.3 ± 0.16 mmol/L, 0.84 ± 0.19 mmol/L, 776.6 ± 531 IU/L, 7.15 ± 4.8 pmol/L and 8 (4-8) respectively. Improvement on last follow up on treatment was seen in ALP (776 ±531 vs 525±232; p <0.001) and Thacher scores (8 (4-8) vs 2 (1-3.5); p =0.01) after 5 years, but no change in phosphate or HAZ. Conclusion: Conventional therapy for treatment of hypophosphatemic rickets is not associated with an improvement in HAZ despite an improvement in radiology and ALP. Adherence is a major challenge for the majority of patients.
dc.description.submitterMMM2025
dc.facultyFaculty of Health Sciences
dc.identifier.citationIsaac, Nikhila. (2023). A retrospective study of the biochemical and radiological profile of children with genetic hypophosphatemic rickets and their response to conventional treatment. [Masterd dissertation, University of the Witwatersrand, Johannesburg]. WIReDSpace. https://hdl.handle.net/10539/44497
dc.identifier.urihttps://hdl.handle.net/10539/44497
dc.language.isoen
dc.publisherUniversity of the Witwatersrand, Johannesburg
dc.rights©2023 University of the Witwatersrand, Johannesburg. All rights reserved. The copyright in this work vests in the University of the Witwatersrand, Johannesburg. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of University of the Witwatersrand, Johannesburg.
dc.rights.holderUniversity of the Witwatersrand, Johannesburg
dc.schoolSchool of Clinical Medicine
dc.subjectAlkaline Phosphatase (ALP)
dc.subjectAnalysis of Covariance (ANOVA)
dc.subjectChris Hani Baragwanath Academic Hospital (CHBAH)
dc.subjectFibroblast Growth Factor 23 (FGF23)
dc.subjectPhosphate regulating endopeptidase homologous on the X chromosome
dc.subjectParathyroid Hormone
dc.subjectGenetic hypophosphatemic rickets
dc.subjectRickets
dc.subjectUCTD
dc.subjectX-Linkco Hypophosphatemia
dc.subjectConventional treatment
dc.subjectBurosumab
dc.subject.primarysdgSDG-3: Good health and well-being
dc.subject.secondarysdgSDG-4: Quality education
dc.titleA retrospective study of the biochemical and radiological profile of children with genetic hypophosphatemic rickets and their response to conventional treatment
dc.typeDissertation

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