 |
|
Severe Myopathy Associated With Vitamin D Deficiency in Western New York
Anu Prabhala, MD;
Rajesh Garg, DM;
Paresh Dandona, MD
Arch Intern Med. 2000;160:1199-1203.
Five cases of severe myopathy associated with vitamin D deficiency are described. Each patient was confined to a wheelchair because of weakness and immobility. Two were elderly, 1 was a 37-year-old African American with type 1 diabetes mellitus, 1 was being treated for carcinoid syndrome, and 1 was severely malnourished due to poor oral intake. In each, weakness had previously been attributed to other causes, including old age, concomitant diabetic neuropathy, or general debility. Correct diagnosis was made initially by a high index of suspicion, following the demonstration of clinical proximal myopathy; confirmation was made by the demonstration of low 25-hydroxyvitamin D and elevated parathyroid hormone concentrations. Treatment with vitamin D caused a resolution of body aches and pains and a restoration of normal muscle strength in 4 to 6 weeks. Four patients became fully mobile and had normal 25-hydroxyvitamin D concentrations, and the fifth also became mobile. In the 4 fully recovered cases, parathyroid hormone levels on follow-up were lower but still elevated. This finding suggests a degree of autonomy of parathyroid secretion known to occur in cases of long-standing vitamin D deficiency. Myopathy, due to chronic vitamin D deficiency, probably contributes to immobility and ill health in a significant number of patients in the northern United States. An awareness of this condition may significantly improve mobility and quality of life in patient populations vulnerable to vitamin D deficiency.
From the Division of Endocrinology, Diabetes and Metabolism, State University of New York at Buffalo (Drs Prabhala and Dandona), and Kaleida Health (Drs Garg and Dandona), Buffalo.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Vitamin D as an Analgesic for Patients With Type 2 Diabetes and Neuropathic Pain
Lee and Chen
Arch Intern Med 2008;168:771-772.
FULL TEXT
Risk Factors for Fracture in Nonosteoporotic Men and Women
Nguyen et al.
J. Clin. Endocrinol. Metab. 2007;92:955-962.
ABSTRACT
| FULL TEXT
Low Vitamin D and High Parathyroid Hormone Levels as Determinants of Loss of Muscle Strength and Muscle Mass (Sarcopenia): The Longitudinal Aging Study Amsterdam
Visser et al.
J. Clin. Endocrinol. Metab. 2003;88:5766-5772.
ABSTRACT
| FULL TEXT
Vitamin D deficiency, muscle function, and falls in elderly people
Janssen et al.
Am. J. Clin. Nutr. 2002;75:611-615.
FULL TEXT
|
