Musculoskeletal manifestations of osteomalacia:report of 26 cases and literature review

Reginato, Antonio J.; Falasca, Gerald F.; Pappu, R.; McKnight, Brian E.; Agha, Amir

doi:10.1016/s0049-0172(99)80013-4

Cited by 135 publications

(64 citation statements)

References 52 publications

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“…Myopathy associated with hypocalcemia is better described in the literature when associated with osteomalacia. In this cases, however, CK tends do be normal 7 , whereas in our case it was strikingly elevated. Since the first description by Wolf et al , there have been very few cases of hypocalcemic myopathy with an increased CK, and almost all of them were due to IHP 1,2,[8][9][10] , but this finding can also be observed in pseudohypoparathyroidism 11 .…”

Section: Discussioncontrasting

confidence: 67%

Hypocalcemic myopathy without tetany due to idiopathic hypoparathyroidism: case report

Nora

Fricke

Becker

et al. 2004

Arq. Neuro-Psiquiatr.

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-Myopathy due to idiopathic hypoparathyroidism is very unusual. We report on a 30 years-old man referred with complaints of sporadic muscle pain and mild global weakness for 10 years. His physical examination showed normal strength in distal muscle and slightly weakness in the pelvic and scapular girdles with no atrophy. Deep muscle reflexes were slightly hypoactive. Trousseau's and Chvostek's signs were absent. He had bilateral cataract and complex partial seizures. His laboratory tests showed decreased ionised and total calcium and parathyroid hormone and increased muscle enzymes. EMG and muscle biopsy was compatible with metabolic myopathy. After treatment with calcium and vitamin D supplementation he showed clinical, neurophisiological and laboratorial improvement. In conclusion: patients with muscle symptoms, even when non-specific and with normal neurological examination, should have serum calcium checked, as myopathy due to idiopathic hypoparathyroidism, even being rare, is treatable and easy to diagnose.KEY WORDS: myopathy, hypocalcemia, hypoparathyroidism. Miopatia hipocalcêmica secundária a hipoparatireiodismo idiopático sem tetamia: relato de casoRESUMO -Miopatia secundária a hipoparatireidismo idiopático é enfermidade raramente descrita. Relatamos o caso de homem de 30 anos que procurou atendimento médico com queixas de dores musculares e discreta fraqueza há cerca de 10 anos. Ao exame físico apresentava leve diminuição de força na musculatura pélvica e escapular, sem atrofia, ou fraqueza distal. Os reflexos miotáticos fásicos eram hipoativos e não havia sinais de Trousseau ou Chevostek. Havia história de catarata bilateral e crises parciais complexas. Os exames laboratoriais demonstraram hipocalcemia, com diminuição do paratormônio, hiperfosfatemia e enzimas musculares elevadas. A EMG e a biópsia de músculo foram compatíveis com miopatia metabóli-ca. Após reposição de cálcio e vitamina D houve melhora clínica e neurofisiológica. Em conclusão: em pacientes com sintomas musculares, mesmo não específicos para miopatia ou com exame neurológico normal, devese dosar cálcio sérico, já que miopatia associada a hipoparatireoidismo é uma doença facilmente diagnosticada e tratável. PALAVRAS-CHAVE: miopatia, hipocalcemia, hipoparatireoidismo.Myopathy due to idiopathic hypoparathyroidism (IHP) is an extremely rare condition, with little more than 10 cases described in the literature, and its pathophysiology is not well established [1][2][3][4] . IHP is an infrequent disease of unknown aetiology, caused by insufficient secretion of parathyroid hormone (PTH). Its estimated prevalence in Japan is 7.2 cases per million individuals 5 . The reduced secretion of this hormone leads to hypocalcemia and hyperphosphatemia, due to the inhibition in calcium reabsorption in distal tubules and bone matrix, and also to the deficiency in the synthesis of 1,25-dihydroxyvitamin D. The clinical manifestations of IHP are multiple and affect mainly tissues of ectodermic origin. Among the most common findings in these patient...

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Section: Discussioncontrasting

confidence: 67%

Hypocalcemic myopathy without tetany due to idiopathic hypoparathyroidism: case report

Nora

Fricke

Becker

et al. 2004

Arq. Neuro-Psiquiatr.

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“…[1] The first entity is related to children and the later one to the adults .Osteomalacia is incomplete mineralization of the osteoid tissue after closure of the growth plates. [2] The presentation can vary in either of the cases. The condition can appear either because of the deficiency of Vit D or in case there is defective absorption and metabolism.…”

Section: Discussionmentioning

confidence: 99%

Mollities Ossium in adolescent child: Radiographic Features –Case Report

Sharma¹,

Sharma²,

Sharma³

et al. 2017

AIMDR

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Mollities ossium is softening of bone because of osteomalacia or rickets.This is either because of non utilization of available calcium,phosphate and vitamin D or because of resorption of bony calcium.Metabolism disturbances lead to deficient bone minerilisation.Rickets is the name of osteomalacia in adults which can also be named as adult rickets. We present a12-years old girl who presented with almost crippling effects of the entity.She was radiologically diagnosed of this pathology which was later confirmed with biochemical parameters.DEXA (Dual Energy X-ray Absorptiometry ) scan was helpful tool for categorizing the grading of the osteopenia.The case was of more academic importance as the features were overlapping between pediatric and adult age group.General radiography played a pivot role in eliciting the various findings relavent to the pathology.

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“…This phenomenon has rarely been reported in patients with hypocalcaemia and myopathy due to hypoparathyroidism [5][6][7][8][9]. While myopathy in long lasting hypocalcaemia associated with osteomalaciais well described, it is not followed by an increase in serum CK levels [10]. Increased CK levels have been linked to tetany, but several reports questioned this hypothesis, noting increased levels of CK in the absence of apparent tetany.…”

Section: Discussionmentioning

confidence: 99%

Severe Hypocalcemia in the Postpartum Period: A Rare Case of Primary Hypoparathyroidism and Autoimmune Thyroid Disease

Veselinović¹,

Pavlović²,

Miljić³

et al. 2013

Thyroid Disorders Ther

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Musculoskeletal manifestations of osteomalacia:report of 26 cases and literature review

Cited by 135 publications

References 52 publications

Hypocalcemic myopathy without tetany due to idiopathic hypoparathyroidism: case report

Hypocalcemic myopathy without tetany due to idiopathic hypoparathyroidism: case report

Mollities Ossium in adolescent child: Radiographic Features –Case Report

Severe Hypocalcemia in the Postpartum Period: A Rare Case of Primary Hypoparathyroidism and Autoimmune Thyroid Disease

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