Aetiology and clinical profile of osteomalacia in adolescent girls in northern India.
Article
in English
| IMSEAR
| ID: sea-119481
ABSTRACT
BACKGROUND:
The adolescent age group is particularly prone to nutritional rickets/osteomalacia due to an increased demand for nutrients, especially calcium and vitamin D. Osteomalacia presents with non-specific signs and symptoms because of which diagnosis may be delayed. Vitamin D deficiency is unexpected in India, which is a tropical country with abundant sunshine.METHODS:
We prospectively studied the clinical presentation, aetiology and social factors contributing to adolescent rickets/ osteomalacia in our region.RESULTS:
We saw 21 symptomatic adolescents with osteomalacia during the study period (November 2000-July 2002). All were girls. Only 1 practised purda and 4 belonged to a low socioeconomic class. The mean (SD) duration of illness before correct diagnosis was 2.8 (2.1) years. Bone pains and muscular weakness were universally present. Non-specific complaints (especially limb pains being mistaken for joint involvement) led to a delay in diagnosis with consequent morbidity. All but 1 patient had low serum 25-hydroxyvitamin D levels (<10 ng/ml), with the mean (SD) being 4.9 (2.7) ng/ml. Their mean dietary calcium intake was low 1265 (199) mg/day, range 40-810 mg/day]. Restricted outdoor activities (n = 19) and the traditional dress code (n = 21) were contributory factors, as they led to poor exposure to sunshine.CONCLUSIONS:
Nutritional osteomalacia among adolescents is a poorly recognized entity. Even in non-purda practising communities in the tropics, poor exposure to sunshine due to social factors, compounded by low dietary calcium intake, can lead to osteomalacia in adolescents.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Osteomalacia
/
Sunlight
/
Vitamin D Deficiency
/
Female
/
Humans
/
Calcium
/
Prospective Studies
/
Risk Factors
/
Adolescent
/
India
Type of study:
Etiology study
/
Observational study
/
Risk factors
Country/Region as subject:
Asia
Language:
English
Year:
2003
Type:
Article
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