Osteomalacia in Sprue

Salvesen, Harald A.; Böe, Jens

doi:10.1111/j.0954-6820.1953.tb10243.x

Cited by 84 publications

(13 citation statements)

References 7 publications

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“…Fifty per cent of adults are diagnosed after 50 years of age (7), and population-based studies suggest that 50% to 90% of people with CD remain undiagnosed (8,9). Metabolic bone disease in CD patients has been reported in the literature for more than 70 years (10)(11)(12), with greater malabsorption leading to greater bone loss. Even subclinical or silent cases have lower bone mineral density (BMD) than healthy controls (13,14).…”

mentioning

confidence: 99%

Evaluation and Management of Skeletal Health in Celiac Disease: Position Statement

Fouda

Khan

Sultan

et al. 2012

Canadian Journal of Gastroenterology

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confidence: 99%

Evaluation and Management of Skeletal Health in Celiac Disease: Position Statement

Fouda

Khan

Sultan

et al. 2012

Canadian Journal of Gastroenterology

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“…Decreased physical activity secondary to pain with secondary hyperparathyroidism and hypocalcaemia also contribute to decreased BMD 16. An association between coeliac disease and osteomalacia was first reported in 1953 17. In coeliac disease, intestinal malabsorption of vitamin D contributes to plasma and urine calcium levels being lower than normal and defective absorption of phosphate consequently leads to hypophosphataemia.…”

Section: Discussionmentioning

confidence: 99%

Coeliac disease causing symptomatic hypocalcaemia, osteomalacia and coagulapathy

McNicholas

Bell²

2010

Case Reports

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A 36-year-old gentleman presented with 6 months of poor energy, tingling in fingers and weight loss with a change in bowel habit. He appeared cachectic and had clubbing, demineralisation of teeth, pectus carinatus, kyphosis, spinal tenderness, proximal muscle weakness and generalised muscle atrophy. Chvostek's and Trosseau's signs were positive. His haemoglobin (Hb) was 8.7 g/dl, MCV 64.7 fl with low iron. Calcium corrected was 1.30 nmol/l, parathyroid hormone 440.4 ng/l, vitamin D <12.5 nmol/l; INR was 2.7 with coagulation inhibitor studies negative. Radiographs of spine and pelvis commented on osteopenia with thoracic kyphosis and mild anterior wedging of thoracic vertebrae. Antitissue transglutaminase was 145 U/ml, and antiendomysial antibodies were positive. An oesophagogastroduodenoscopy was consistent with coeliac disease. A diagnosis of osteomalacia and coagulopathy secondary to coeliac disease was made. The hypocalcaemia was treated with calcium gluconate infusions with symptomatic relief. Coagulopathy was treated with vitamin K intravenously with normalisation of INR. Following treatment with coeliac diet, calcium slowly normalised.

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“…In fact, osteomalacia, rickets, bone pain, and osteoporosis have even been reported as presenting clinical features of celiac disease [28][29][30]. The use of non-invasive techniques for measurement of bone mass and application of biochemical indicators to the study of bone metabolism have unraveled the magnitude of the problem, and indicated possible pathogenic causes for the bone disorder in celiac disease.…”

Section: Bone Health Of Celiac Childrenmentioning

confidence: 99%

Celiac disease in children: Impact on bone health

Mora¹

2008

Rev Endocr Metab Disord

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Celiac disease is a chronic enteropathy caused by permanent intolerance to gluten and similar proteins found in wheat, barley and rye. The intestinal mucosa of susceptible individuals is crossed by undigested gluten, which leads to a marked inflammatory response. The clinical features may vary from overt intestinal symptoms to silent disease. Bone health has been found to be markedly affected in children and adolescents with untreated celiac disease, regardless of clinical presentation. Bone mass measurements are greatly reduced compared to healthy youth. As indicated by surrogate markers of bone turnover, bone formation rates are depressed and bone resorption rates enhanced in untreated patients. The causes underlying alterations in bone metabolism are still under investigation, but are attributed to non-intestinal factors. Increased production of inflammatory cytokines and presence of specific autoantibodies may together disrupt bone metabolism equilibrium in children and adolescents with celiac disease. Gluten withdrawal is able to restore bone mass quite rapidly, with a normalization of levels of bone formation and bone resorption markers. Good adherence to gluten-free diet is mandatory to maintain optimal bone health. Monitoring of dietary compliance is important to ensure appropriate bone mass accrual through childhood and puberty in these patients, to maximize peak bone mass and reduce fracture risk later in life.

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Osteomalacia in Sprue

Cited by 84 publications

References 7 publications

Evaluation and Management of Skeletal Health in Celiac Disease: Position Statement

Evaluation and Management of Skeletal Health in Celiac Disease: Position Statement

Coeliac disease causing symptomatic hypocalcaemia, osteomalacia and coagulapathy

Celiac disease in children: Impact on bone health

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