Abstract
To assess potential skeletal muscle changes of high energy phosphate compounds and inorganic phosphate (P) in early childhood rickets, a non-invasive but direct estimate of the relative concentrations in gastrocnemius muscle of P, phosphocreatine (PCr), & adenosine triphosphate (ATP) was measured by magnetic resonance spectroscopy (MRS) in an infant, age 10 months. He had generalized weakness and low serum P (3.5mg/dl) and Ca (6.7mg/ dl). Therapy was begun with vitamin D & dietary P & Ca, and weekly 31-P MRS spectra were obtained in an Oxford 30 cm, 1.9T magnet. Initially, PCr was approximately 50% reduced compared to that in gastrocnemius of a normal 6-month infant. Tissue P, PCr & ATP gradually normalized, preceding return of serum P & Ca to normal. Data below are serum (Ser) values, & tissue peak heights (mm) and peak height ratio:
Functional muscle tone & strength gradually improved in concordance with MRS spectral return to a normal pattern. High energy phosphate depletion may explain the hypotonia of rickets. MRS may uniquely allow definition of individual muscle phosphorus components over time.
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Mize, C., Corbett, R., Uauy, R. et al. IN VIVO TIME COURSE OF MUSCLE PHOSPHOCREATINE, PHOSPHORUS, AND ADENOSINE TRIPHOSPHATE DURING TREATMEN OF RICKETS. Pediatr Res 21 (Suppl 4), 345 (1987). https://doi.org/10.1203/00006450-198704010-01065
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DOI: https://doi.org/10.1203/00006450-198704010-01065