Department of Clinical and Experimental Medicine, Institute of Internal Medicine, Angiology and Arteriosclerosis Diseases, University of Perugia, Perugia, Italy.
J Clin Rheumatol. 2010 Jan;16(1):34-7. doi: 10.1097/RHU.0b013e3181c3b2c0.
A 20-year-old vegetarian man was admitted to our hospital complaining of muscle weakness and gait disturbances of 4 years duration. For the past 5 years, he had major depression and had confined himself at home. He exhibited tenderness upon palpation of the chest, sternum and proximal muscles. Hypocalcemia, hypophosphatemia, vitamin D deficiency, increased levels of alkaline phosphatase, and intact parathyroid hormone were noted. An x-ray skeletal survey revealed generalized osteopenia, multiple vertebral and costal fractures, and a pelvis deformed into the shape of a triangle. A diagnosis of osteomalacia secondary to vitamin D deficiency from lack of exposure to sunlight and to inadequacy of the diet was made. The patient was started on a treatment with 20,000 IU of vitamin D3 once a week plus 1 g/d of calcium. Eight months later, gait disturbances have significantly improved and laboratory findings have all normalized.
一位 20 岁的素食男性因肌肉无力和步态障碍 4 年而入院。在过去的 5 年中，他患有重度抑郁症，一直闭门在家。他的胸部、胸骨和近端肌肉触诊时有压痛。检查发现低钙血症、低磷血症、维生素 D 缺乏、碱性磷酸酶水平升高和完整的甲状旁腺激素。骨骼 X 线检查显示全身骨质疏松症、多发性肋骨和胸骨骨折，以及骨盆呈三角形变形。诊断为维生素 D 缺乏引起的佝偻病，缺乏阳光照射和饮食不足导致。患者开始每周服用 20,000IU 的维生素 D3 一次，每天 1 克钙。8 个月后，步态障碍明显改善，实验室检查结果均恢复正常。
