Rickets with Alopecia: Remission Following a Course of 1-Alpha-Hydroxy Vitamin D3 Therapy

In the 1989 study, a child with rickets and alopecia who did not improve after receiving high doses of vitamin D3 showed remission following treatment with a low dose of 1-α-hydroxyvitamin D3 (1-α-OH D3). The treatment with 1-α-OH D3 was administered for 2 years, and upon discontinuation, the child did not exhibit any signs of rickets relapse after 1 year. However, the alopecia remained unchanged. After stopping treatment, the child's serum 25-hydroxycholecalciferol and parathormone levels were normal, but serum 1,25-dihydroxycholecalciferol was elevated. This case suggests that the child's condition did not conform to the typical classification of vitamin D dependent rickets type II (VDDR II), as the good response to physiological doses of 1-α-OH D3 is more characteristic of VDDR type I. The temporary requirement for 1-α-OH D3 therapy in this case is notable, and it remains unclear whether the child would have recovered without treatment.