title: [Metabolic bone disease osteomalacia].
abstract: Osteomalacia is a rare disorder of bone metabolism leading to reduced bone mineralization. Underlying vitamin D deficiency and a disturbed phosphate metabolism (so-called hypophosphatemic osteomalacia) can cause the disease. Leading symptoms are dull localized or generalized bone pain, muscle weakness and cramps as well as increased incidence of falls. Rheumatic diseases, such as polymyalgia rheumatica, rheumatoid arthritis, myositis and fibromyalgia must be considered in the differential diagnosis. Alkaline phosphatase (AP) is typically elevated in osteomalacia while serum phosphate and/or 25-OH vitamin D3 levels are reduced. The diagnosis of osteomalacia can be confirmed by an iliac crest bone biopsy. Histological correlate is reduced or deficient mineralization of the newly synthesized extracellular matrix. Treatment strategies comprise supplementation of vitamin D and calcium and for patients with intestinal malabsorption syndromes vitamin D and calcium are also given parenterally. In renal phosphate wasting syndromes substitution of phosphate is the treatment of choice, except for tumor-induced osteomalacia when removal of the tumor leads to a cure in most cases.
authors.affiliation: Fachklinik für Rheumatologie und Onkologie, Klinik Am Kurpark, Rehazentren Baden-Württemberg, Kurhausstr. 9, 97688, Bad Kissingen, Deutschland, m.reuss-borst@rehaklinik-am-kurpark.de.
authors.forename: M A
authors.initials: MA
authors.lastname: Reuss-Borst
mesh_terms: D000469:Alkaline Phosphatase / Q000502:physiology; D015519:Bone Density / Q000187:drug effects / Q000502:physiology*; D001842:Bone and Bones / Q000187:drug effects / Q000503:physiopathology*; D002118:Calcium / Q000627:therapeutic use; D006801:Humans; D010003:Osteoarthritis / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D010018:Osteomalacia / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D010257:Paraneoplastic Syndromes / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D063730:Rickets, Hypophosphatemic / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D014807:Vitamin D / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000188:drug therapy / Q000503:physiopathology
chemical_list: D014807:Vitamin D; D000469:Alkaline Phosphatase; D002118:Calcium