title: A case report of osteomalacia unmasking primary biliary cirrhosis.
abstract: Osteomalacia, a metabolic bone disease characterized by the inability to mineralize new osteoid, can be caused by vitamin D deficiency. We report a patient with symptomatic, biochemical, and imaging evidence of osteomalacia due to vitamin D deficiency, who as a result of work up for bone disease was diagnosed with early primary biliary cirrhosis. Osteomalacia was treated with high-dose vitamin D and serial bone density scans showed evidence of increasing bone mineral density suggesting osteoid mineralization in response to treatment. The diagnosis of cholestatic liver disease should be considered in all patients presenting with osteomalacia due to vitamin D deficiency, particularly if other cholestatic liver enzymes are elevated in addition to alkaline phosphatase.
authors: Prohealth Clinical Research Center, Prohealth, 150-943W Broadway, Vancouver, BC, V5Z 4E1, Canada, monikap@ualberta.ca.
authors: M
authors: M
authors: Pawlowska
authors: J E
authors: JE
authors: Kapeluto
authors: D L
authors: DL
authors: Kendler
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000209:etiology; D008105:Liver Cirrhosis, Biliary / Q000150:complications* / Q000175:diagnosis*; D010018:Osteomalacia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014807:Vitamin D / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000150:complications / Q000188:drug therapy
chemical_list: D014807:Vitamin D