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Osteomalacia


Description

Vitamin D deficiency results in rickets in children and osteomalacia in adults.

Osteomalacia is characterized by an abnormally high ratio of osteoid (inadequately mineralized bone matrix) to mineralized bone.

Symptoms include:

* Diffuse bone pain, especially in the hips

* Muscle weakness

* Bone fractures with minimal trauma



Causes

Osteomalacia is a complex and protean disorder, with over 30 causes or associated diseases identified.

Conditions that may lead to osteomalacia include:

* Inadequate dietary intake of vitamin D

* Inadequate exposure to sunlight (ultraviolet radiation), which produces vitamin D in the body

* Malabsorption of vitamin D by the intestines



Other conditions that may cause osteomalacia include:

* Hereditary or acquired disorders of vitamin D metabolism

* Kidney failure and acidosis

* Phosphate depletion associated with low dietary intake of phosphates

* Kidney disease or cancer (rare)

* Side effects of medications used to treat seizures



Use of very strong sunscreen, limited exposure of the body to sunlight, short days of sunlight, and smog are factors that decrease formation of vitamin D within the body.



Risk factors for osteomalacia are related to the causes. In the elderly, there is an increased risk among people who tend to remain indoors and those who avoid milk because of lactose intolerance.

Conventional Labs

* A bone biopsy shows osteomalacia.

* Serum vitamin D level may be low.

* Serum calcium levels vary with the cause of the disorder.

* Serum phosphate levels vary with the cause of the disorder.

* A bone X-ray may show features of osteomalacia.

* A bone mineral density scan (DEXA) may show reduced bone mineral density.



Other tests may be done to determine renal problems or other underlying disorders. They include:

* PTH

* Calcium (ionized)

* ALP (alkaline phosphatase) isoenzyme


 

 

 

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