Abstract
Osteomalacia may be defined as bone disorder characterized by defective mineralization, which leads to accumulation of unmineralized matrix or osteoid in the skeleton. It occurs from decreased presence of calcium or phosphate for incorporation into the hydroxyapatite of bone or due to deficient absorption or activation of vitamin D. It may result from reduced availability of vitamin D as a consequence of inadequate sunlight exposure, insufficient intake of vitamin, or malabsorption in patients with GIT disease. The insidious onset of bone pain with progressive nature and muscle weakness are characteristics features of osteomalacia. We experienced a case of osteomalacia presented with proximal muscle weakness with marked anterior chest pain in a veil wearer 38 year old woman caused by vitamin D deficiency due to malabsorption and lack of sunlight exposures.
Keywords: Osteomalacia, Hypovitaminosis-D, Rehabilitation
References
- Francis RM, Selby LP, Osteomalacia. Bailliere’s Clinical Endocrinology & Metabolism1997; 11(1):145-63
- LeBoff Ms, Kohlmeier L, Hurwitz S, Frankling J, Wright J, Glowack J. Occult vitamine D deficiency in postmenopausal US women with acute hip fracture. JAMA.1992;281:1505-11.
- Holick MF, garabedian M: Vitamin D: photobiology, metabolism, mechanism of action, and clinical applications. In Favus MJ, editor:Primer on the metabolic bone diseases and disorders of mineral metabolism, ed 6, Washington DC, 2006, American Society for Bone and Mineral Research: 106-14
- Yosephin B, Riyadi H, Anwar F, Khomsan A. Is vitamin D defiiency associated with using veil in female garment workers. Asian Pacific Journal of Tropical Disease. 6. 481-485. 10.1016/S2222-1808(16) 61072-1.
- Ryan EA, Reiss E. Oncogenous osteomalacia. Review of the world literature & report of 2 new cases. An J Med.1984;77: 501-12
- Pitt MJ. Rickets and osteomalacia are still around. Radiol Clin North Am 1991;29(1): p.97-118.
- Bhan A, Rao AD, Rao DS, Osteomalacia as a Result of Vitamin D Deficiency Endocrinol Metab Clin N Am 39 (2010). 321–31
- Parfitt AM, Rao DS, Stanciu J, et al. Irreversible bone loss in osteomalacia: comparison of radial photon absorpti-ometry with iliac bone histomorphometry during treatment. J Clin Invest 1985;76: 2403–12.
- Parfitt AM. Osteomalacia and related disorders. In: Avioli LV, Krane SM, editors. Metabolic bone disease and clinically related disorders. Philadelphia: WB Saunders;1990.329–96.
- Dent CE, Freidman M. Brit medical Journal. Hypophosphataemic osteomalacia with complete recovery.1964.27. Jun 1964.
- Michael P Whyte, Rajesh V Thakker.Genetics of bone biology and skeletal disease,Bone disorder, 2013 Elsevier Ltd.594-99
- Brickley, M., Mays, S., Ives, R. An investigation of skeletal indicators of vitamin D deficiency in adults: effective markers for interpreting past living conditions and pollution levels in 18th and 19th century Birmingham, England. Am. J. Phys.Anthropol:2007);132:67–79.
- Clunie GPR, Ralston SH. Rheumatology and Bone Disease. Davidson’s principle and practice of Medicine. Chap 24.23rd Elseiver.1051-53
- Pablo Florenzano, Rachel I. Gafnia, Michael T. Collins, Tumor-induced osteomalacia. Bone Reports 7 (2017) 90–97.
- Choong-Kyun Noh, Min-Jeong Lee, Bu Kyung Kim, Yoon-Sok Chung. A Case of Nutritional Osteomalacia in Young Adult Male, J Bone Metab 2013;20:51-55.
- Russell LA, Osteoporosis and Osteomalacia. Rheum Dis Clin N Am 36 (2010):665–80
- Velmir Matkovic, Jackson R, Whitten R.Osteoporosis. Chap-57. KRUSEN’S Handbook of Physical Medicine and Rehabilitation. 4th Philadelphia. 1916;1198.
- Bringhurst FR, Marie B. demay, Stephen M. Krane, Henry M. kronenberg. Bone and mineral Metabolism in health and Disease. Chap-423. Harrison’s principle of Internal Medicine. 19th Mc graw Hill, New York.2015.2464-66.
- Salam SN, Eastell R, Khwaja A. Fragility fractures and osteoporosis in CKD: pathophysiology and diagnostic methods. Am J Kidney Dis 2014;63 (6):1049–59.
Corresponding Author
Dr Md. Nuruzzaman Khandaker
Assistant Professor, Room no. 600/A, Cabin Block, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka, Bangladesh