Stage | Serum calcium (Ca) | Serum inorganic phosphorus (Pi) | Parathyroid hormone (PTH) | Mechanisms | Radiologic and clinical findings of rickets |
1 | Low or normal | Normal | Normal or elevated | Vitamin D deficiency causes impaired intestinal absorption of calcium | None, or osteopenia only |
2 | Normal | Low | Elevated | Elevated PTH mobilizes calcium from bone, retains calcium at the kidney, and promotes production of 1,25(OH)2D | Clinically apparent rickets (radiographic and/or physical findings in the skeleton) |
3 | Low | Low | Very elevated | Serum calcium falls as hyperparathyroidism is unable to compensate for impaired intestinal calcium absorption. Hyperparathyroidism may also lead to aminoaciduria and hyperphosphaturia.* | Severe radiographic and physical signs of rickets |
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