vitamin-b-12 and Osteomalacia

A 32-year-old patient with anorexia nervosa since adolescence was admitted because of diffuse bone pain, increasing during the 2 preceding winters. She had a special aversion to dairy products and all forms of dietary fat. Low normal serum calcium and very low calciuria were noted, with a highly elevated bone fraction of alkaline phosphatase, and severe hypovitaminosis D and B12. Apart from a recent spontaneous fracture of the clavicle, Looser lines and pseudofractures were noted in a finger, fibula and malleolus. In particular, magnetic resonance imaging of the knee showed additional evidence of a pseudofracture in the femur, and medullary changes were found. Evidence for secondary hyperparathyroidism was described. Apart from the well known occurrence of osteoporosis, our case shows that osteomalacia may exceptionally occur in anorexia nervosa.

Topics: Adult; Alkaline Phosphatase; Anorexia Nervosa; Bone and Bones; Calcium; Female; Humans; Knee Joint; Magnetic Resonance Imaging; Osteomalacia; Osteoporosis; Radionuclide Imaging; Vitamin B 12; Vitamin D

Severe osteomalacia with secondary hyperparathyroidism was observed in a 19-year-old mentally retarded girl, who had been treated for several years with antiepileptic drugs. Vitamin D3 orally administered in low doses led to complete reversal of all symptoms and normalization of blood chemistry, X-ray pictures demonstrated healing of all lesions. It is suggested that the alterations of vitamin-D metabolism occuring during the administration of phenobarbital and hydantion are of importance only in patients with an already lowered intake of vitamin D3 or reduced exposure to ultraviolet rays.

Topics: Adult; Anticonvulsants; Bicarbonates; Blood Proteins; Calcium; Cholecalciferol; Cholesterol; Creatinine; Female; Fractures, Bone; Hematocrit; Hemoglobins; Humans; Hyperparathyroidism; Osteomalacia; Vitamin B 12

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Child; Crohn Disease; Duodenal Ulcer; Female; Folic Acid; Folic Acid Deficiency; Humans; Ileitis; Intestinal Absorption; Intestine, Small; Jejunum; Male; Middle Aged; Osteomalacia; Potassium; Radiography; Serum Albumin; Vitamin B 12

Topics: Aged; Aging; Anemia, Hypochromic; Blood Glucose; Blood Sedimentation; Calcium; Cholesterol; Clinical Laboratory Techniques; Creatinine; Diabetes Mellitus; Female; Folic Acid; Geriatrics; Hemoglobinometry; Humans; Iodine; Iron; Leukocyte Count; Male; Osteomalacia; Phosphoric Monoester Hydrolases; Protein Binding; Thyroid Diseases; Urea; Uric Acid; Vitamin B 12

Topics: Adolescent; Anemia, Macrocytic; Anticonvulsants; Antitubercular Agents; Calcium; Celiac Disease; Child; Contraceptives, Oral; Drug-Related Side Effects and Adverse Reactions; Female; Folic Acid; Folic Acid Deficiency; Humans; Iatrogenic Disease; Male; Middle Aged; Neomycin; Nutrition Disorders; Osteomalacia; Pyridoxine; Rickets; Vitamin B 12

Topics: Adult; Aged; Alkaline Phosphatase; Anemia, Hypochromic; Body Weight; Calcium; Duodenal Ulcer; Female; Follow-Up Studies; Gastroenterostomy; Hemoglobins; Humans; Male; Metabolism; Middle Aged; Osteomalacia; Sex Factors; Time Factors; Tuberculosis, Pulmonary; Vagotomy; Vitamin B 12

Clinical and laboratory signs of neurological disease were found in 14 patients many years after partial gastrectomy. Vitamin B(12) deficiency occurred in most patients, but only those three who had signs of subacute combined degeneration of the cord and no osteomalacia responded well to treatment.

Topics: Adult; Aged; Escherichia coli; Female; Gastrectomy; Humans; Jejunum; Male; Middle Aged; Neurologic Manifestations; Osteomalacia; Peripheral Nervous System Diseases; Spinal Cord Diseases; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Age Factors; Aged; Anabolic Agents; Folic Acid; Heart Diseases; Humans; Nicotinic Acids; Osteomalacia; Osteoporosis; Pyridoxine; Vitamin B 12

Topics: Abortion, Spontaneous; Anemia, Hemolytic, Congenital; Animals; Ascorbic Acid; Ergocalciferols; Female; Humans; Hydrocephalus; Infant, Newborn; Infant, Newborn, Diseases; Jaundice, Neonatal; Maternal-Fetal Exchange; Osteomalacia; Pregnancy; Pregnancy, Prolonged; Pyridoxine; Rats; Scurvy; Seizures; Skull; Vitamin A; Vitamin B 12; Vitamin E; Vitamin K; Vitamins