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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.
Subject(s)
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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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