A 20-month-old child with nutritional rickets (alkaline phosphatase 850 IU/L, wrist widening, bow legs) is being treated. According to current IAP recommendations, which regimen should be used for the curative phase?
- A Vitamin D 400 IU daily alone for 12 weeks
- B A single oral mega-dose of 600,000 IU with no follow-up supplementation
- C Vitamin D 60,000 IU weekly for 8 weeks along with dietary calcium, followed by 400 to 800 IU daily ✓
- D Calcium 500 mg daily alone until radiological healing
Correct answer: C. Vitamin D 60,000 IU weekly for 8 weeks along with dietary calcium, followed by 400 to 800 IU daily
Explanation
IAP guidance for active nutritional rickets beyond infancy uses weekly vitamin D 60,000 IU for 8 weeks (total approximately 480,000 IU) combined with calcium supplementation, then maintenance 400 to 800 IU daily. Calcium must accompany treatment because healing demands mineral substrate; giving calcium alone delays cure. Maintenance doses of 400 IU daily are preventive and far too small to heal established rickets, while a single unsupervised mega-dose risks both under-treatment and hypercalcemia monitoring failures.
Reference: Ghai Essential Pediatrics, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.