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"lead": "заболевание быстрорастущего организма, характеризующееся нарушением минерального обмена и костеобразования",
"description": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Рахит — это заболевание, которое возникает при нарушениях обмена фосфора и кальция, из-за чего растущая костная ткань не минерализируется. Болезнью страдают только дети, преимущественно грудного и раннего возраста.</span></p>",
"etiology": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Причины рахита</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Недоношенность. В последние месяцы беременности к плоду максимально поступает кальций и фосфор, поэтому недоношенные дети попадают в группу риска развития рахита с вероятностью до 80%.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Неправильное вскармливание. В группу риска попадают дети на искусственном или нерациональном вскармливании, при котором в организм с пищей поступает недостаточное количество кальция и фосфора, витамина А, В, микроэлементов, с однообразным белковым или липидным рационом.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Недостаток минералов, вызванный их повышенной потребностью в период интенсивного роста организма.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Нарушение транспортировки кальция и фосфора в ЖКТ, почках и костях, что вызвано незрелостью ферментных систем, патологиями развития или нарушениями в работе указанных органов.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Особенности экологии, когда в окружающей среде содержится избыток хрома, железа, стронция, солей свинца или, наоборот, обнаруживается дефицит магния.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Половые особенности. По статистике к развитию рахита больше предрасположены мальчики, они же и переносят его тяжелее, чем девочки.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Дефицит витамина D.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Эндокринные нарушения, например, поражение щитовидной или паращитовидных желез.</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Генетическая предрасположенность.</span></li>\r\n</ul>",
"pathogenesis": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Витамин D поступает в организм с едой и пищевыми добавками, а также образуется в коже под воздействием солнечного света. Чтобы поступивший из пищи витамин D стал активным, ему предстоит пройти две последовательные реакции окисления:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">первая реакция протекает в печени, в результате образуется кальцидиол;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">вторая реакция проходит в почках и завершается выработкой активной формы — кальцитриола.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Кальцитриол контролирует обмен кальция в организме. При низкой концентрации ионов кальция он способствует его мобилизации из костной ткани. Также кальцитриол повышает содержание кальция и фосфора во внеклеточной жидкости, что укрепляет растущие кости.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В метаболизме витамина D важная роль принадлежит паратгормону — гормону паращитовидной железы. При дефиците витамина D развивается гипокальциемия, из-за чего избыточно вырабатывается паратгормон, что ведёт к потере фосфора и снижает отложение кальция в костях.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">На начальной стадии рахита снижается концентрация кальция в сыворотке крови. При этом активируется паратгормон, что возвращает уровень кальция в норму, но содержание фосфора остаётся низким. Щелочная фосфатаза просачивается во внеклеточную жидкость, её концентрация повышается от умеренной до очень высокой. </span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Щелочная фосфатаза вырабатывается остеобластами — сверхактивными клетками костной ткани, играющими важную роль в её формировании и обновлении. Чем выше их активность, тем больше концентрация щелочной фосфатазы в крови, поэтому её уровень высок после переломов.</span></p>",
"diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Ди­аг­ноз ра­хи­та устанавливается на основании клинических признаков, подтвержденных лабо­ра­тор­ными и рент­ге­но­ло­ги­че­скими данными. Для уточнения степени нарушения минерального обмена проводится биохимическое исследование крови и мочи. Важнейшими лабораторными признаками, позволяющими думать о рахите, служат гипокаль­ци­е­мия и ги­по­фос­фа­те­мия; увеличение ак­тив­но­сти щелочной фосфатазы; снижение уровня ли­мон­ной ки­с­ло­ты, каль­ци­ди­о­ла и каль­ци­т­ри­о­ла. При исследовании КОС крови выявляется аци­доз. Изменения в анализах мочи характеризуются гипераминоа­ци­ду­рией, ги­пер­фос­фа­ту­рией, ги­по­каль­ци­у­рией. Про­ба Сул­ковича при рахите от­ри­ца­тель­ная.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При рентгенографии трубчатых костей выявляются характерные для рахита изменения: бокаловидное расширение метафизов, нечеткость гра­ниц ме­ж­ду ме­та­фи­зом и эпи­фи­зом, ис­тон­че­ние кор­ко­во­го слоя диа­фи­зов, неотчетливая визуализация ядер око­сте­не­ния, остеопороз. Для оценки состояния костной ткани может использоваться денситометрия и КТ трубчатых костей. Проведение рентгенографии позвоночника, ребер, черепа, нецелесообразно ввиду выраженности и специфичности в них клинических изменений.</span></p>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Комплексная медицинская помощь ребенку с рахитом складывается из организации правильного режима дня, рационального питания, медикаментозной и немедикаментозной терапии. Детям, страдающим рахитом, необходимы ежедневное пребывание на свежем воздухе в течение 2-3 часов, достаточная инсоляция, более раннее введение прикорма, закаливающие процедуры (воздушные ванны, обтирания). Важное значение имеет правильное питание кормящей мамы с приемом витаминно-минеральных комплексов.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Специфическая терапия рахита требует назначения витамина D в лечебных дозах в зависимости от степени тяжести заболевания: при I ст. – в суточной дозе 1000-1500 МЕ (курс 30 дней), при II - 2000-2500 МЕ (курс 30 дней); при III - 3000-4000 МЕ (курс – 45 дней). После окончания основного курса витамин D назначается в профилактической дозе (100-200 МЕ/сут.). Лечение рахита следует проводить под контролем пробы Сулковича и биохимических маркеров для исключения развития гипервитаминоза D. Поскольку при рахите часто отмечается полигиповитаминоз, детям показан прием мультивитаминных комплексов, препаратов кальция, фосфора.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Неспецифическое лечение рахита включает массаж с элементами ЛФК, общее УФО, бальнеотерапию (хвойные и хлоридно-натриевые ванны), аппликации парафина и лечебных грязей.</span></p>\r\n<p><span id=\"docs-internal-guid-d860e7dd-7fff-b1ab-cc79-4480cb9d89a6\"> </span></p>",
"prevention": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Профилактику рахита нужно начинать ещё до рождения ребёнка. Пища беременной женщины должна содержать достаточно калорий, белков, жиров, углеводов, минеральных солей и витаминов. Обязательны прогулки на свежем воздухе и здоровый образ жизни. Специфическая профилактика в этом периоде заключается в приёме витамина D. Учитывая, что в России часто встречается его дефицит, всем женщинам, готовящимся к зачатию, желательно получать витамин D в профилактических дозах (не менее 600–800 МЕ витамина D в сутки). При наступлении беременности дозу увеличивают до 800–1200 МЕ в сутки.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Постнатальная профилактика рахита начинается сразу после рождения ребёнка. Предпочтительнее естественное вскармливание, но важно своевременно ввести прикорм. Также нужно заниматься гимнастикой, принимать воздушные ванны, проводить массаж, водные процедуры, гулять на свежем воздухе и поддерживать положительный эмоциональный тонус ребёнка.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Специфическая профилактика рахита заключается в приёме витамина D.</span></p>",
"clinical_picture": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Начальный период рахита приходится на 2-3-й месяцы жизни ребенка, а у недоношенных детей - на середину или конец 1-го месяца жизни. Первичная симптоматика незначительна, поэтому зачастую не привлекает внимания родителей. Ранними признаками рахита служат:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">беспокойство, гипервозбудимость,</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">тревожный сон, частые вздрагивания во сне,</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">плохой аппетит,</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">потливость, особенно в области волосистой части головы (пот имеет специфический кислый запах),</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">появление стойких опрелостей,</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">мышечная гипотония,</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">большой размер родничка, очаговое размягчение затылочных костей,</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">на голове появляется четкий рисунок подкожных вен,</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">стул неустойчивый, моча приобретает резкий запах аммиака.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Продолжительность начального периода рахита составляет от 1 до 3 месяцев.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В период разгара заболевания, который обычно приходится на 5-6-й месяцы жизни, отмечается прогрессирование остеомаляции. Об остром течении рахита могут говорить следующие признаки:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">медленный набор веса и роста;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">«олимпийский» лоб (увеличение лобных бугров);</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">реберные «четки» (полушаровидное утолщение в месте перехода хрящевой части ребра в костную);</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">дугообразная впадина под ребрами – Гаррисонова борозда;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">деформация грудной клетки в виде «куриной груди» (килевидная грудная клетка) или «груди сапожника» (воронкообразная грудная клетка);</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">формирование кифоза («рахитического горба»);</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">рахитические «браслетики» на лучезапястных суставах;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">«нити жемчуга» (утолщения в области фаланг пальцев);</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">О и Х-образное искривление нижних конечностей, плоскостопие из-за слабости мышц и связок;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">деформация костей таза (плоский таз);</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">выпуклый («лягушачий») живот;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">позднее прорезывание зубов, дефекты эмали и кариес молочных, а позже и коренных зубов;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">задержка психомоторного развития: неспособность удерживать голову, сидеть, стоять, ползать, ходить.</span></li>\r\n</ul>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Кроме костных деформаций, рахит сопровождается увеличением печени и селезенки, выраженной анемией.</span></p>\r\n<p><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\"> </span></p>",
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