Osteomalacia after small-intestinal resection.
Histological examination of bone from 25 patients with small-intestinal resection showed that 9 (36%) had osteomalacia, which was severe in 5 and mild in 4. The serum-alkaline-phosphatase concentration was raised in all patients with severe osteomalacia, but serum calcium, phosphate, and alkaline-phosphatase concentrations were normal in the 4 patients with mild disease, 2 of whom had symptoms. Osteomalacia was diagnosed radiologically in only 3 patients. Osteomalacia appears to be commoner in patients with small-intestinal resection than has previously been thought, and bone biopsy is essential if all cases are detected. Although high-dose parenteral vitamin-D therapy is usually effective in the treatment of osteomalacia after small-intestinal resection, our findings showed that oral vitamin-D metabolites and their analogues may also be effective. This has important practical advantages.
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D001842:Bone and Bones / Q000473:pathology; D002118:Calcium / Q000097:blood; D003424:Crohn Disease / Q000601:surgery; D004872:Ergocalciferols / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007273:Injections, Intramuscular; D007583:Jejunum / Q000601:surgery*; D008286:Malabsorption Syndromes / Q000150:complications* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010018:Osteomalacia / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D010710:Phosphates / Q000097:blood; D011183:Postoperative Complications / Q000453:epidemiology*; D014807:Vitamin D / Q000008:administration & dosage / Q000378:metabolism
D004872:Ergocalciferols; D010710:Phosphates; D014807:Vitamin D; D000469:Alkaline Phosphatase; D002118:Calcium