[Non-tropical sprue, a frequently unrecognized cause of high-grade generalized osteopathy]

Average interval from initial symptoms to diagnosis in 47 patients with non-tropical sprue was 8.3 years. Predominantly skeletal symptoms without typical gastro-intestinal symptoms occurred in about one third of cases, probably a reason for the delay in diagnosis. In more than 90% of cases there was the histological picture of osteopathy, osteomalacia with or without secondary hyperparathyroidism being about twice as frequent than osteoporosis. Biochemical and histological findings correlated well. In more than 80% of cases the mean mineral content of the radius bone was reduced by more than 30% of normal, while radiological findings were abnormal in only just half the cases. Even in the absence of diarrhoea, non-tropical sprue should be considered in aetiologically uncertain cases of generalised osteopathy.