Oral 25-hydroxyvitain D3 in treatment of osteomalacia associated with ileal resection and cholestyramine therapy.
Severe histological osteomalacia developed in a woman with Crohn's disease 2 years after ileal resection and the start of cholestyramine therapy. Treatment with oral 25-hydroxyvitamin D3, 50 microgram daily, produced marked biochemical, radiological, and histological improvement after 6 months. It is suggested that cholestyramine, by reducing vitamin D absorption, precipitated the rapid development of osteomalacia in this patient. This case report emphasizes the importance of routine vitamin D supplementation in all patients on long term cholestyramine therapy, and indicates that even in patients with small intestinal disease or resection, oral preparations of vitamin D or its metabolities and analogues may be effective.
D000284:Administration, Oral; D000469:Alkaline Phosphatase / Q000097:blood; D002118:Calcium / Q000097:blood; D002792:Cholestyramine Resin / Q000009:adverse effects* / Q000627:therapeutic use; D003967:Diarrhea / Q000188:drug therapy; D005260:Female; D006801:Humans; D006887:Hydroxycholecalciferols / Q000008:administration & dosage* / Q000627:therapeutic use; D007082:Ileum / Q000601:surgery*; D008875:Middle Aged; D010018:Osteomalacia / Q000139:chemically induced / Q000188:drug therapy* / Q000209:etiology; D010710:Phosphates / Q000097:blood; D011183:Postoperative Complications
D006887:Hydroxycholecalciferols; D010710:Phosphates; D002792:Cholestyramine Resin; D000469:Alkaline Phosphatase; D002118:Calcium