Hereditary Vitamin D Resistant Rickets: Clinical, Laboratory, and Genetic Characteristics of Two Iranian Siblings

    Ali A. Ghazi, Azita Zadeh–Vakili, Marjan Zarif Yeganeh, Shahram Alamdari, Atieh Amouzegar, Ali Akbar Khorsandi, Alireza Amirbaigloo, Fereidoun Azizi
    TLDR Two siblings with a genetic mutation had a form of rickets that doesn't respond to vitamin D.
    In 2017, a study was conducted on two Iranian siblings suffering from Hereditary Vitamin D Resistant Rickets (HVDRR), a rare disease characterized by rickets, alopecia, and growth retardation. The siblings, followed for 27 years, exhibited symptoms like rickets, growth retardation, muscle weakness, hypocalcemia, and alopecia totalis since early childhood. Genetic testing revealed a mutation in the VDR gene, causing their resistance to vitamin D. Despite treatment with high doses of calcium and active vitamin D, no significant improvement was observed in their condition. The study concluded that genetic testing is crucial for diagnosing HVDRR and that normal hair growth depends on the interaction of Vitamin D Receptor (VDR) with a nuclear transcription factor named hairless protein (Hr). The male sibling had severe bone loss, while the female sibling had normal Bone Mineral Density (BMD), despite having a more severe form of the disease.
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