RENAL RICKETS WITH METASTATIC CALCIFICATION AND PARATHYROID DYSFUNCTION

Abstract

There have been many excellent reports on the demineralization of bone in association with chronic diffuse nephritis (renal rickets), but the condition is still imperfectly understood. To quote Hunter,¹"the theory that phosphate retention, due to the renal defect, is primarily responsible for the changes in the bones is clearly unsatisfactory." The dwarfing, polyuria and polydipsia, which are not infrequent and which strongly suggest an endocrine factor, are likewise unexplained. A lemon yellow tint to the skin, anemia and weakness of the musculature are commonly associated with chronic nephritis, but these conditions are also found in hyperparathyroidism. The case summarized in the following report is of interest because of the opportunity it afforded to study some of the metabolic and pathologic factors in detail. <h3>REPORT OF A CASE</h3> <i>History.</i>—D. R., a boy aged 14 years, was referred to the pediatric service in April 1932 with the following history: