title: Hypovitaminosis D-related myopathy in immigrant teenagers.
abstract: BACKGROUND
  Vitamin D deficiency resulting in a limb-girdle muscle weakness was diagnosed in three veiled immigrant teenage girls.
  
  
  METHODS
  Three girls had a progressive muscle weakness and pain during a period varying from 6 months to two years. On examination limb girdle muscle weakness, predominantly of the lower extremities, without other neurological abnormalities was found. Serum examination showed a decreased level of vitamin D and phosphate and an increased alkaline phosphatase, and in two girls decreased calcium and increased parathyroid hormone levels were found. After supplementation with vitamin D, the pain subsided and muscle strength increased within weeks. Serum examination of the female relatives revealed eight persons with hypovitaminosis D, without any complaints.
  
  
  CONCLUSIONS
  Vitamin D deficiency can result in a limb-girdle myopathy in veiled immigrant teenagers in the Netherlands. Vitamin D supplementation leads to rapid recovery of the muscle strength. The female relatives of these patients should be examined too.
authors.affiliation: Department of Paediatric Neurology, University Medical Centre Nijmegen, The Netherlands. J.vanderHeyden@cukz.umcn.nl
authors.forename: J J C
authors.initials: JJ
authors.lastname: van der Heyden
authors.forename: A
authors.initials: A
authors.lastname: Verrips
authors.forename: H J
authors.initials: HJ
authors.lastname: ter Laak
authors.forename: B
authors.initials: B
authors.lastname: Otten
authors.forename: T
authors.initials: T
authors.lastname: Fiselier
mesh_terms: D000293:Adolescent; D002648:Child; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D007493:Iraq / Q000208:ethnology; D018908:Muscle Weakness / Q000209:etiology*; D009426:Netherlands; D012998:Somalia / Q000208:ethnology; D014808:Vitamin D Deficiency / Q000150:complications* / Q000208:ethnology