[Vitamin D deficiency. Easy to diagnose, often overlooked].
On the basis of five cases the typical clinical picture of patients with severe vitamin D deficiency is presented. The diagnosis can easily be mistaken and it is not uncommon that rheumatic or malignant diseases are suspected instead. By using a simple screening blood test consisting of 25-OH-vitamin D, PTH and alkaline phosphatase most cases will be diagnosed correctly. Important risk factors are reviewed, the most important being: elderly > 70 years, persons with low exposure to direct sunlight, gastrointestinal diseases and persons in anti-convulsive treatment. A treatment regimen consisting of oral supplementation of 1000-1500 mg calcium + 1000 IU vitamin D to patients with an isolated low 25-OH-vitamin D (< 20 nmol/l) is recommended. If the patient also has raised values of PTH or alkaline phosphatase an intramuscular dose of 100,000 IU ergocalciferol pr week for one month is given.
D000368:Aged; D018912:Arabs; D015519:Bone Density; D001842:Bone and Bones / Q000473:pathology; D002136:Calcium, Dietary / Q000008:administration & dosage; D003718:Denmark / Q000208:ethnology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014807:Vitamin D / Q000008:administration & dosage; D014808:Vitamin D Deficiency / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy