Rachitic respiratory distress in small preterm infants

Abstract

Respiratory difficulty is common during early infancy, particularly in preterm babies. Although often caused by a primary abnormality of the lungs or heart this is not invariably so. A syndrome of subacute respiratory distress, severe metabolic bone disease affecting the thoracic cage, and mild cholestasis occurred in 4 small preterm infants during the first three months of life and was associated with considerable morbidity. The early radiological features in the chest resembled those of the Mikity Wilson syndrome, with which the disorder may be confused. After spontaneous improvement in hepatic function 3 of the infants fully recovered. The 4th died of paralytic ileus. Various nutritional and absorptive abnormalities probably contribute to the pathogenesis of the bone disorder in this syndrome. The best prophylaxis might be to supplement the diet with 25 hydroxyvitamin D rather than native vitamin D.