Avitaminosis D and Pathologic Fractures in a Young Woman

作者：Stojkovic Mirjana^*; Beleslin Biljana; Ciric Jasmina; Savic Slavica; Mirkovic Dusko; Trobojevic Bozo; Zarkovic Milos

来源：Endocrinologist, 2009, 19(2): 71-72.

DOI：10.1097/TEN.0b013e318198bb10

• vitamin D deficiency
• parathyroid hormone
• fractures
• malabsorption
• celiac disease

A 29-year-old woman with Down syndrome was admitted with a fracture of the left femur and increased parathyroid hormone (PTH) levels. She had a 13-year history of muscle and bone pain, which caused difficulties in walking. Bone densimetry (dual-energy x-ray absorptiometry) showed low bone density (Z score [L2-L4]: -6.75 SD). Total and ionized calcium (Ca) and calciuresis were low (Ca, 1.69 mmol/L: Ca( ), 0.98 mmol/L: U Ca, 0, 16 mmol/24 h), the alkaline phosphatase level was increased (236 U/L). Serum vitamin D level (25 [OH]D) was undetectable and parathyroid hormone was elevated (124.8 ng/L). Antiendomysial antibodies were positive. Celiac disease was diagnosed as the cause of malabsorption syndrome. A gluten-free diet and Supplementation of vitamin D and calcium was started. Treatment resulted in weight Lain. correction of anemia, normalization of calcium (Ca( ), 1.12 mmol/L). and 25 (OH)D levels (90.7 nmol/L). Vitamin D deficiency is more common than expected. and in cases of pathologic fracture and disturbance of the calcium metabolism. it should always be considered.

• 出版日期2009-4
• 单位河北医科大学