Vitamin D deficiency remains common in
children and
adults in
Pakistan despite adequate
sunlight exposure.
Diagnosis in
adults is usually delayed and is made following
pathological fractures that result in significant
morbidity. The objective of this study was to see whether
Serum Alkaline Phosphatase levels could be used as a
screening test for
osteomalacia. The Study was conducted at Fatima
Hospital, Baqai Medical
University, Gadap, Karachi, between July 2002 and June 2005.
Serum calcium levels are commonly used to screen
patients suspected of
osteomalacia, and raised
serum alkaline phosphatase [SALP] is considered a diagnostic finding. We used SALP to screen
patients who presented with
back or non-specific
aches and
pain of more than six months duration. Three hundred thirty-four [334]
patients were screened of which 116 [35%] had raised SALP.
Osteomalacia was diagnosed in 92 [79.3%] of these 116 either by plain radiographs,
bone biopsy or
isotope bone scan. Fifty-four [53.4%] of the 101 cases had a normal level of
serum calcium.
Osteomalacia is likely to be missed if only
serum calcium is used to screen
patients.
Serum Alkaline
Phosphate should be used as the preferred
method for
screening these
patients