Osteomalacia

  1. A. Quesada Moreno 1
  2. M.D. Sánchez González 1
  3. C. Hidalgo Calleja 1
  4. C. Montilla Morales 1
  5. J. del Pino-Montes 1
  1. 1 Servicio de Reumatología. Hospital Universitario de Salamanca. Universidad de Salamanca. Salamanca. España
Journal:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Year of publication: 2016

Issue Title: Enfermedades endocrinológicas y metabólicas (IV) Patología del metabolismo fosfocálcico

Series: 12

Issue: 16

Pages: 909-914

Type: Article

DOI: 10.1016/J.MED.2016.07.004 DIALNET GOOGLE SCHOLAR

More publications in: Medicine: Programa de Formación Médica Continuada Acreditado

Abstract

Aetiology Osteomalacia and rickets are entities related to a bone mineralisation defect. The most common cause is severe vitamin D deficiency, which in Spain takes place in conditions of social exclusion and malabsorption. Less common causes include congenital and acquired vitamin D metabolism abnormalities, various types of hypophosphataemia and the presence of mineralisation inhibitors. There is a paraneoplastic form of osteomalacia related to tumours that express the phosphaturic hormone FGF-23. Clinical manifestations The clinical condition is usually asymptomatic but can include bone pain and muscle weakness. Tetany is observed in cases with severe hypocalcaemia. In highly progressed forms, radiology shows biconcave vertebra or long bone deformation with Looser's zones (pseudofractures). When there is a vitamin D deficiency, blood levels of 25(OH)2D, calcium, phosphorus and calciuria are decreased, while blood phosphatase alkaline and PTH levels are high. Diagnosis and treatment The diagnosis is confirmed by bone histomorphometry. It is important to treat the cause of the osteomalacia, if possible. For vitamin D deficiency, the deficit is corrected by ensuring a proper intake of calcium. Very high doses of vitamin D are sometimes necessary.

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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 Society

Funders

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