title: [Ten fractures in 21 years].
abstract: A 78 year old woman had suffered ten spontaneous bone fractures, the first occurring when she was 57 years old. She is now wheel-chair bound. After 21 years, the underlying osteomalacia due to oligosymptomatic celiac disease with malabsorption was diagnosed. The treatment consists of a gluten free diet and substitution of calcium and vitamin D until there is a normalisation of calcium, vitamin D and alkaline phosphatase. Any spontaneous fracture deserves a careful search for metabolic bone disease. An elevation of alkaline phosphatase indicates osteomalacia rather than osteoporosis.
authors.affiliation: Abteilung für Innere Medizin, HELIOS-Klinik Zwenkau. jfritzsch@zwenkau.helios-kliniken.de
authors.forename: J
authors.initials: J
authors.lastname: Fritzsch
authors.forename: G
authors.initials: G
authors.lastname: Hennicke
authors.forename: A
authors.initials: A
authors.lastname: Tannapfel
mesh_terms: D000368:Aged; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D005598:Fractures, Spontaneous / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D010018:Osteomalacia / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy