Myelofibrosis in severe vitamin D deficiency rickets.

Vitamin D deficiency is prevalent in infants and children in the underdeveloped countries. Infants with mild deficiency tend to present with complications like hypocalcemic seizures whereas occurrence of pathological features in advanced rickets is well elucidated. Secondary myeloflbrosis has been reported as a complication of severe rickets and in these children anemia, myeloid metaplasia and bone marrow aplasia strongly suggested myelofibrosis. Despite the high prevalence of rickets in the IndoPakistan subcontinent, there has been no report on this complication.We present a case of severe clinical rickets who had developed secondary myelofibrosis with hepatosplenomegaly. The purpose of presentation is to highlight this rare complication and increase clinician’s awareness. The pathogenesis of myelofibrosis in rickets is discussed with emphasis on the reversible nature of the disease.