INTRACTABLE HYPOPHOSPHATEMIC RICKETS WITH RENAL GLYCOSURIA AND ACIDOSIS (THE FANCONI SYNDROME)

Abstract

Severe rickets of the familiar variety, due to dearth of sunlight or lack of proper food, has virtually disappeared from communities which have adopted the regular prophylactic use of vitamin D. This noteworthy development has served to give prominence to the less common species which are causally dependent on intrinsic peculiarities of metabolism. Boyd¹ has properly stressed the diversity of clinical aspect which characterizes many of the examples of metabolic, or endogenous, rickets. This feature is undeniably worthy of emphasis. However, it is not warranted to conclude that lack of obvious or complete congruence among the reported cases invariably denotes that they are fundamentally dissimilar. In many instances the discordance is more apparent than real, reflecting chiefly the superficial level to which medical investigation is often necessarily restricted. The literature abounds in cases of endogenous rickets which for want of critical information cannot be exactly interpreted: Of these the