Nutritional rickets and severe hypocalcemia in two Canadian newcomers

Abstract

Nutritional rickets and hypocalcemia are serious but preventable medical conditions with important and potentially long-lasting health implications. Despite well-established recommendations around dietary modification and nutritional supplementation, these diseases remain disproportionately higher among Canadian newcomers. We describe two cases of nutritional rickets and hypocalcemia in adolescent newcomers from East Africa. Both children attended a primary care clinic on arrival to Canada, but neither child was taking appropriate supplementation at the time of diagnosis. Once diagnosed, both patients responded to supplementation but, due to the severity and chronicity of their nutritional deficiencies, required additional medical testing and intervention to achieve adequate management. This case report emphasizes Canadian newcomers as an at-risk group for nutritional rickets and hypocalcemia, and underlines an urgent need for improved awareness, dietary counselling, supplementation, and access to reliable long-term prescription coverage upon arrival to Canada.