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Osteomalacia in Crohn's disease
Meryem Dedeoglu1, Yesim Garip, Hatice Bodur
1Department of Physical Medicine and Rehabilitation, Anamur State Hospital, Mersin, Turkey, drmeryemdedeoglu@gmail.com.
Archives of Osteoporosis
|May 23, 2014
Summary
Osteomalacia, a bone disorder, can arise from vitamin D deficiency in Crohn's disease patients. Prompt vitamin D and calcium supplementation effectively treats symptoms and prevents complications.
Area of Science:
- Endocrinology
- Gastroenterology
- Rheumatology
Background:
- Osteomalacia is a metabolic bone disease marked by impaired bone matrix mineralization, often linked to vitamin D or phosphate metabolism issues.
- Vitamin D deficiency, frequently caused by malabsorption syndromes like Crohn's disease, is a common etiology of osteomalacia.
Observation:
- A 43-year-old male with a six-year history of seronegative spondyloarthropathy and Crohn's disease presented with fatigue, low back pain, and morning stiffness.
- Diagnostic workup revealed low serum calcium, low 25-hydroxy vitamin D3, normal phosphorus, elevated parathyroid hormone, and alkaline phosphatase levels, alongside grade IV sacroiliitis and Looser zones on radiographs.
Findings:
- The patient was diagnosed with osteomalacia secondary to vitamin D malabsorption.
- Treatment with vitamin D and calcium supplements led to the resolution of his symptoms and clinical signs.
Implications:
- Osteomalacia should be a key consideration in the differential diagnosis of low back pain among patients with chronic inflammatory bowel disease.
- Aggressive vitamin D supplementation is crucial for patients with Crohn's disease to prevent the development of osteomalacia.
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