Unrecognised severe vitamin D deficiency

doi:10.1136/bmj.39555.820394.BE

BMJ 2008;336:1371-1374 (14 June), doi:10.1136/bmj.39555.820394.BE

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Unrecognised severe vitamin D deficiency

John L Sievenpiper, visiting elective medical student¹, Elizabeth A McIntyre, specialist registrar, Mark Verrill, consultant and senior lecturer¹, Richard Quinton, consultant and senior lecturer¹, Simon H S Pearce, consultant and professor¹

¹ Endocrine Unit, Royal Victoria Infirmary, Newcastle Upon Tyne NE1 4LP

Correspondence to: S Pearce S.H.S.Pearce@ncl.ac.uk

Vitamin D deficiency remains common and may mimic other musculoskeletaldisorders or mental health problems

The first 150 words of the full text of this article appear below.

Since Glisson gave the first authoritative description of ricketsin 1650 and McCollum and coworkers described its cause as vitaminD deficiency in 1922,¹ clinical descriptions of hypovitaminosisD have become more variable, making the condition less recognisable.²At the same time, the condition remains highly prevalent worldwide, yet is preventable.³ We present two cases of longstandingundiagnosed severe vitamin D deficiency with important clinicalconsequences.

A 53 year old woman of Pakistani origin underwent mastectomyfor invasive ductal carcinoma of the right breast with adjuvantradiotherapy and tamoxifen treatment. Over the next two yearsshe presented at her follow-up appointments with migratory musculoskeletalpains, including pain in the right arm, loin, right posteriorchest with bony tenderness and whole body discomfort. A chestx ray showed an irregularity of the upper cortex of the rightposterolateral seventh rib. An isotope bone scan showed multipleareas of increased radionuclide . . . [Full text of this article]

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This article has been cited by other articles:

Quinton, R., Pearce, S. H S, Sievenpiper, J. L (2008). Time to go to get your hat. BMJ 337: a1130-a1130 [Full text]
Rhein, H. M (2008). Vitamin D deficiency is widespread in Scotland. BMJ 336: 1451-1451 [Full text]

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