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Rickets?! How did she get Rickets? Lauren’s mother asks you.

Merchak Case Challenge # 79 - July 2026 Rickets?! How did she get Rickets? Lauren’s mother asks you. You are caring for Lauren. Lauren is a 10 weeks old infant born at 24-week Gestational age. She spent 4 weeks on the ventilator and has a history of rule out sepsis twice and rule out Necrotizing Enterocolitis (NEC) once. Lauren in supported via Nasal CPAP, and she is receiving Breast milk with fortification via NG tube. Her medications are Caffeine, Diuretics and Iron supplementations. The radiologist calls you with findings of Rachitic rosary seen on her chest XR. Her most recent labs are as follows: Ionized Ca: 0.9 mmol/L, Calcium: 8.2 mg/dL, Phosphorus: 3.5 mg/dL, ALK Phos 843 U/L. Na: 139 mmol/L, K: 4.6 mmol/L, CL: 98 mmol/L, Co2: 27 mmol/dL. You are discussing the findings with the family.

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