#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Acquired osteomalacia: case report from clinical practice


Authors: Klímová Judita
Authors‘ workplace: Osteocentrum, III. interní klinika – klinika endokrinologie a metabolismu 1. LF UK a VFN v Praze
Published in: Clinical Osteology 2023; 28(3): 52-55
Category:

Overview

Osteomalacia belongs to the metabolic osteopathies and is characterized by a mineralization disorder of the newly formed osteoid. The etiology of the disease is broad and includes congenital and acquired causes. These causes usually lead to a lack of mineralization substrates (calcium, phosphates) or to an impaired mineralization process. In practice, the clinical picture of osteomalacia can be incomplete, and the laboratory picture can include a wide range of deviations. For these reasons, the diagnosis of osteomalacia may be delayed or mistaken for another skeletal pathology. Osteomalacia is routinely included in the differential diagnosis when low bone density is found, although it is less common in clinical practice compared to osteoporosis. The treatment of the disease depends on the underlying cause, and with the correct diagnosis, a full cure can occur. We present a case report of a patient from a standard inpatient ward, in whom the diagnosis of osteomalacia was not clear. The case report includes a 75-year-old cachectic patient with malnourished osteomalacia with unrecognized chronic pancreatitis.

Keywords:

malabsorption syndromes – osteomalacia – chronic pancreatitis– malabsorption osteomalacia


Sources

1. Priemel M, von Domarus C, Klatte TO et al. Bone mineralization defects and vitamin D deficiency: histomorphometric analysis of iliac crest bone biopsies and circulating 25-hydroxyvitamin D in 675 patients. J Bone Miner Res 2010; 25(2): 305–312. Dostupné z DOI: <http://dx.doi.org/10.1359/jbmr.090728>.

2. Cianferotti L. Osteomalacia Is Not a Single Disease. Int J Mol Sci 2022; 2 3(23): 1 4896. Dostupné z DOI: < http://dx.doi.org/10.3390/ijms232314896>.

3. Collins MT, Marcucci G, Anders HJ et al. Skeletal and extraskeletal disorders of biomineralization. Nat Rev Endocrinol 2022; 18(8): 473–489. Dostupné z DOI: <http://dx.doi.org/10.1038/s41574–022–00682–7>.

4. Uday S, Hogler W. Nutritional Rickets and Osteomalacia in the Twenty-first Century: Revised Concepts, Public Health, and Prevention Strategies. Curr Osteoporos Rep 2017; 15(4): 293–302. Dostupné z DOI: <http://dx.doi.org/10.1007/s11914–017–0383-y>. Erratum in Curr Osteoporos Rep 2017; 15(5): 507. Dostupné z DOI: <http://dx.doi.org/10.1007/s11914–017–0395–7>.

5. Haugeberg G. Imaging of metabolic bone diseases. Best Pract Res Clin Rheumatol 2008; 22(6): 1127–1139. Dostupné z DOI: <http://dx.doi.org/10.1016/j.berh.2008.09.016>.

6. Kumar KH, Sood AK, Manrai M. Occult metabolic bone disease in chronic pancreatitis. Niger J Clin Pract 2017; 20(9): 1122–1126. Dostupné z DOI: <http://dx.doi.org/10.4103/njcp.njcp_42_17>.

7. Sikkens EC, Cahen DL, Koch AD et al. The prevalence of fat-soluble vitamin deficiencies and a decreased bone mass in patients with chronic pancreatitis. Pancreatology 2013; 13(3): 238–242. Dostupné z DOI: <http://dx.doi.org/10.1016/j.pan.2013.02.008>.

8. Dujsikova H, Dite P, Tomandl J et al. Occurrence of metabolic osteopathy in patients with chronic pancreatitis. Pancreatology 2008; 8(6): 583–586. Dostupné z DOI: <http://dx.doi.org/10.1159/000159845>.

9. Ghazi AA, Amirbaigloo A. Hypocalcemia and osteomalacia after bariatric surgery. Clin Cases Miner Bone Metab 2017; 14(2): 227–229. Dostupné z DOI: <http://dx.doi.org/10.11138/ccmbm/2017.14.1.227>.

10. Alarfaj HM, Alrasheed WY, Alsulaiman SA et al. A Case Report of Severe Osteomalacia in a Young Patient After Bariatric Surgery. Cureus 2021; 1 3(12): e 20198. Dostupné z DOI: < http://dx.doi.org/10.7759/cureus.20198>.

11. De Prisco C, Levine SN. Metabolic bone disease after gastric bypass s urgery for o besity. A m J Med S ci 2 005; 3 29(2): 5 7–61. Dostupné z DOI: <http://dx.doi.org/10.1097/00000441–200502000–00001>.

12. Rino Y, Aoyama T, Atsumi Y et al. Metabolic bone disorders after gastrectomy: inevitable or preventable? Surg Today 2022; 52(2): 182–188. Dostupné z DOI: <http://dx.doi.org/10.1007/s00595–021–02253–1>.

13. Albany C, Servetnyk Z. Disabling osteomalacia and myopathy as the only presenting features of celiac disease: a case report. Cases J 2009; 2 (1): 2 0. Dostupné z DOI: < http://dx.doi.org/10.1186/1757–1626–2-20>.

14. Tahiri L, Azzouzi H, Squalli G et al. Celiac disease causing severe osteomalacia: an association still present in Morocco! Pan Afr Med J 2014; 1 9: 4 3. Dostupné z DOI: < http://dx.doi.org/10.11604/pamj.2014.19.43.2757>.

15. Sahebari M, Sigari SY, Heidari H et al. Osteomalacia can still be a point of attention to celiac disease. Clin Cases Miner Bone Metab 2011; 8(3): 14–15.

16. Allan PJ, Lal S. Metabolic bone diseases in intestinal failure. J Hum Nutr Diet 2020; 33(3): 423–430. Dostupné z DOI: <http://dx.doi.org/10.1111/jhn.12726>.

17. Dedeoglu M, Garip Y, Bodur H. Osteomalacia in Crohn’s disease. Arch Osteoporos 2014; 9: 177. Dostupné z DOI: <http://dx.doi.org/10.1007/s11657–014–0177–0>.

Labels
Clinical biochemistry Paediatric gynaecology Paediatric radiology Paediatric rheumatology Endocrinology Gynaecology and obstetrics Internal medicine Orthopaedics General practitioner for adults Radiodiagnostics Rehabilitation Rheumatology Traumatology
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#