title: [Osteomalacia in immigrants: therapeutic management of two cases].
abstract: BACKGROUND
  Vitamin D deficiency in immigrant adults eventually leads to an osteomalacia syndrome with its characteristic clinical features of bone pain, muscle weakness and difficulty in walking (waddling gait).
  
  
  METHODS
  We report on 2 female immigrants from Ethiopia and Eritrea who developed the typical clinical signs of osteomalacia such as generalized bone pain and muscle weakness. Also in osteomalacia there is a significant decrease in bone density but more relevant for diagnosis are low serum levels of 25-OH-vitamin D and as radiological features pseudofractures (Looser's zones). Bone biopsy definitely proves the diagnosis. Simple treatment with vitamin D and calcium is highly effective.
  
  
  CONCLUSIONS
  Since there is an increasing number of immigrants into northern European countries osteomalacia should always be taken into consideration if such patients develop skeletal pain syndrome and muscle weakness.
authors.affiliation: Medizinische Klinik 4, Akademisches Lehrkrankenhaus, Universität Köln.
authors.forename: A
authors.initials: A
authors.lastname: Cöster
authors.forename: J D
authors.initials: JD
authors.lastname: Ringe
mesh_terms: D000328:Adult; D004641:Emigration and Immigration; D019017:Eritrea / Q000208:ethnology; D005002:Ethiopia / Q000208:ethnology; D005260:Female; D005858:Germany; D006801:Humans; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology*; D010018:Osteomalacia / Q000175:diagnosis* / Q000188:drug therapy / Q000208:ethnology / Q000209:etiology*; D010146:Pain / Q000209:etiology*; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D