RECOVERY FROM METABOLIC BONE-DISEASE IN A GIRL WITH VITAMIN-D DEFICIENCY RICKETS ASSOCIATED WITH PRIMARY HYPERPARATHYROIDISM

We describe a 13 year-old Ethiopian girl with vitamin D deficiency ric kets. Hypercalcemia, increased serum alkaline phosphatase and PTH leve ls, together with low serum levels of 25-hydroxyvitamin D and 24,25-di hydroxyvitamin D suggested the co-existence of primary hyperparathyroi dism. The surgical removal of a parathyroid adenoma led to bone healin g and normalization of blood chemistry, We conclude that vitamin D def iciency masked the hyperparathyroidism and hypercalcemia, while excess PTH secretion delayed the cure of rickets until successful parathyroi dectomy had been carried out.