Hypocalcemic tetany in a toddler with undiagnosed rickets

A 17-month-old black girl presented to the pediatric emergency department w ith sudden onset of her hands and feet "drawing up." A diagnosis of vitamin D deficiency rickets with tetany was made on a history of exclusive breast -feeding, low serum calcium, phosphorus, and 25-hydroxyvitamin D levels, an d bone radiographs. Nutritional rickets should be considered in the differe ntial diagnosis of acute hypocalcemia.