Osteomalacia in a hemodialysis patient receiving an active vitamin D sterol.
BACKGROUND
A 17-year-old Filipino male hemodialysis patient presented for renal transplant evaluation. He had significant skeletal abnormalities characterized by bone pain, an inability to walk, and secondary hyperparathyroidism despite therapy with an active vitamin D sterol (paricalcitol).


METHODS
The patient underwent a physical examination, and his serum levels of calcium, phosphorus, alkaline phosphatase, parathyroid hormone, aluminum and 25-hydroxycholecalciferol (25OH-vitamin D) were determined. X-rays of hips and lower extremities, MRI, and bone histomorphometry after double tetracycline labeling were performed.


METHODS
Osteomalacia associated with low 25OH-vitamin D levels.


RESULTS
Monthly therapy with ergocalciferol (vitamin D2) and discontinuation of paricalcitol.
Hernandez
Joel D
JD
David Geffen School of Medicine at UCLA, CA, USA.
Wesseling
Katherine
K
Boechat
M Ines
MI
Gales
Barbara
B
Salusky
Isidro B
IB
D000293:Adolescent; D050071:Bone Density Conservation Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004872:Ergocalciferols / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications / Q000188:drug therapy*; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D010018:Osteomalacia / Q000097:blood / Q000139:chemically induced*; D006435:Renal Dialysis / Q000009:adverse effects*; D014808:Vitamin D Deficiency / Q000097:blood / Q000139:chemically induced
D050071:Bone Density Conservation Agents; D004872:Ergocalciferols; C084656:paricalcitol