Nutritional osteomalacia: Substantial clinical improvement and gain in bone density posttherapy

Hassan Al-Ali, G. El Hajj Fuleihan

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

A 52-yr-old white female presented with worsening low back and hip pain, associated with lower limb proximal muscle weakness and a waddling gait. Her laboratory evaluation revealed hypocalcemia, hypophosphatemia, a very low 25- hydroxyvitamin D level of less than 5 ng/ml, and a bone mineral density in the osteoporotic range. Her laboratory studies were consistent with osteomalacia, although this diagnosis was not established by histomorphometry. She avoided dairy products, spent little time outdoors, and when she went out, she covered her face, arms, and legs. She was on no medications. Her workup for malabsorption including sprue was negative. She was treated with calcium plus high-dose vitamin D 600,000 IU intramuscularly twice within 2 mo and had an impressive clinical improvement. Her difficulty with ambulation improved within 1 wk of start of therapy. Her bone mineral density increased by 40% at the spine and 35% at the hip at 4 mo of therapy, by 63% and 39% at 10 mo, and by 62% and 52% at 15 mo at these sites, respectively. Treatment of osteomalacia is extremely rewarding, with dramatic clinical improvement and normalization of bone mineral density.

Original languageEnglish (US)
Pages (from-to)97-101
Number of pages5
JournalJournal of Clinical Densitometry
Volume3
Issue number1
DOIs
StatePublished - Jan 1 2000
Externally publishedYes

Fingerprint

Osteomalacia
Bone Density
Hip
Gallopamil
Mobility Limitation
Hypophosphatemia
Dairy Products
Hypocalcemia
Muscle Weakness
Celiac Disease
Low Back Pain
Gait
Vitamin D
Lower Extremity
Leg
Spine
Arm
Therapeutics
Calcium

Keywords

  • Bone mineral density
  • Bone pain
  • Nutritional osteomalacia
  • Vitamin D deficiency
  • Weakness

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Nutritional osteomalacia : Substantial clinical improvement and gain in bone density posttherapy. / Al-Ali, Hassan; Fuleihan, G. El Hajj.

In: Journal of Clinical Densitometry, Vol. 3, No. 1, 01.01.2000, p. 97-101.

Research output: Contribution to journalArticle

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