Protocolo diagnóstico y tratamiento de la osteomalacia
- Canabal, G. Manzano
- Vega, M.E. Acosta de la
- Calleja, C. Hidalgo
- Morales, C. Montilla
- del Pino-Montes, J.
ISSN: 0304-5412
Year of publication: 2018
Issue Title: Enfermedades óseas Osteoporosis. Paget óseo. Síndrome de dolor regional complejo
Series: 12
Issue: 60
Pages: 3542-3546
Type: Article
More publications in: Medicine: Programa de Formación Médica Continuada Acreditado
Abstract
Osteomalacia is a bone mineralisation defect in mature bone. The most common cause is a severe vitamin D deficiency, which in our environment occurs in situations of social exclusion or malabsorption. It is generally clinically asymptomatic, but there can be bone pain and muscle weakness. Tetany is observed in cases with severe hypocalcaemia. In very evolved forms, x-ray shows biconcave vertebrae or deformity of the long bones with Looser's pseudofractures. When there is a vitamin D deficiency, serum levels of 25(OH)2D, calcium, phosphorus descend, while alkaline phosphatase and PTH levels rise. Diagnosis is confirmed by bone histomorphometry. It is important to treat the cause of osteomalacia, if possible. A vitamin D deficiency is corrected by ensuring adequate intake of calcium. Occasionally very high doses of vitamin D will be required.
Funding information
Pathogenesis and diagnostic criteria for rickets and osteomalacia–proposal by an expert panel supported by the Ministry of Health, Labour and Welfare, Japan, the Japanese Society for Bone and Mineral Research, and the Japan Endocrine SocietyFunders
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