Osteomalacia,

Osteomalacia, is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

  • Osteomalacia is characterized by defective mineralization of osteoid. Bone biopsy reveals increased thickness of osteoid seams and decreased mineralization rate, assessed by tetracycline labeling.
  • Suboptimal vitamin D nutrition, indicated by plasma 25-hydroxy vitamin D (25[OH]D) levels <30 ng/mL, is very common and contributes to the development of osteoporosis.
  • Etiology includes the following:
    • Dietary vitamin D deficiency
    • Malabsorption of vitamin D and calcium because of intestinal, hepatic, or biliary disease
    • Disorders of vitamin D metabolism (e.g., renal disease, vitamin D–dependent rickets)
    • Vitamin D resistance
    • Chronic hypophosphatemia
    • Renal tubular acidosis
    • Hypophosphatasia

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General Principles

  • Osteomalacia is characterized by defective mineralization of osteoid. Bone biopsy reveals increased thickness of osteoid seams and decreased mineralization rate, assessed by tetracycline labeling.
  • Suboptimal vitamin D nutrition, indicated by plasma 25-hydroxy vitamin D (25[OH]D) levels <30 ng/mL, is very common and contributes to the development of osteoporosis.
  • Etiology includes the following:
    • Dietary vitamin D deficiency
    • Malabsorption of vitamin D and calcium because of intestinal, hepatic, or biliary disease
    • Disorders of vitamin D metabolism (e.g., renal disease, vitamin D–dependent rickets)
    • Vitamin D resistance
    • Chronic hypophosphatemia
    • Renal tubular acidosis
    • Hypophosphatasia

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