Background: Vitamin D deficiency remains an important pediatric health problem because it can lead to nutritional rickets, impaired bone mineralization, delayed growth, muscle weakness, and severe hypocalcemic complications, especially in infants and other high-risk groups. Despite being preventable, it continues to present diagnostic and therapeutic challenges in everyday pediatric practice. Objective: This review summarizes current evidence on the epidemiology, risk factors, clinical manifestations, diagnostic difficulties, treatment, and prevention of vitamin D deficiency in children. Methods: A structured search of PubMed/MEDLINE and the Cochrane Library was conducted on March 28, 2026. Priority was given to pediatric guidelines, consensus statements, systematic reviews, meta-analyses, randomized trials, and observational studies. Results: Available evidence shows that low circulating vitamin D levels are common worldwide, whereas overt rickets and hypocalcemic presentations are concentrated in identifiable vulnerable populations. Diagnostic difficulties arise from inconsistent biochemical thresholds, assay variability, and the need to distinguish nutritional rickets from genetic or renal disorders. Current management relies on risk-based assessment, appropriate vitamin D replacement, adequate calcium intake, and monitoring for adverse effects, while prevention centers on infant supplementation and public health measures that improve adherence. Conclusions: Pediatric vitamin D deficiency is largely preventable, but improved diagnostic harmonization, laboratory standardization, and stronger implementation of prevention programs remain necessary to reduce avoidable morbidity.
Abdulgater et al. (Wed,) studied this question.