Vitamin D Deficiency: Difference between revisions
Nicole Hess (talk | contribs) No edit summary |
Nicole Hess (talk | contribs) No edit summary |
||
Line 53: | Line 53: | ||
== Case Reports/ Case Studies == | == Case Reports/ Case Studies == | ||
'''Case Report #1 ''' === | |||
'''Authors''':<br>Clement Z, Ashford M, and Sivakumaran | '''Authors''':<br>Clement Z, Ashford M, and Sivakumaran<br> | ||
<br> | |||
'''Abstract''': | '''Abstract''': | ||
*Vitamin D deficiency is extremely common in multiple myeloma, and it represents a surrogate for clinical multiple myeloma disease status. Patients may complain of dull, persistent, generalized musculoskeletal aches and pains with fatigue or decrease in muscle strength. | *Vitamin D deficiency is extremely common in multiple myeloma, and it represents a surrogate for clinical multiple myeloma disease status. Patients may complain of dull, persistent, generalized musculoskeletal aches and pains with fatigue or decrease in muscle strength. | ||
*This case highlights that vitamin D deficiency is common in patients with multiple myeloma, and can cause generalized musculoskeletal pain and increase the risk of falls, yet it often goes unrecognized. In patients with non-specific musculoskeletal pain, and inadequate sun-exposure medical practitioners must have a high index of suspicion for vitamin D deficiency. | *This case highlights that vitamin D deficiency is common in patients with multiple myeloma, and can cause generalized musculoskeletal pain and increase the risk of falls, yet it often goes unrecognized. In patients with non-specific musculoskeletal pain, and inadequate sun-exposure medical practitioners must have a high index of suspicion for vitamin D deficiency.<br> | ||
<br> | |||
'''Patient Characteristics:''' | '''Patient Characteristics:''' | ||
*63 year old man with multiple myeloma | *63 year old man with multiple myeloma | ||
*Current reactivation of herpes zoster | *Current reactivation of herpes zoster'''<br>''' | ||
'''<br>''' | |||
'''Subjective''': Chief complaints include: | '''Subjective''': Chief complaints include: | ||
Line 76: | Line 71: | ||
*Generalized weakness | *Generalized weakness | ||
*Nonspecific musculoskeletal pain | *Nonspecific musculoskeletal pain | ||
*Reported multiple falls | *Reported multiple falls<br> | ||
<br> | |||
'''Examination:''' | '''Examination:''' | ||
Line 86: | Line 79: | ||
*Muscle weakness | *Muscle weakness | ||
*Waddling gait | *Waddling gait | ||
*Bone studies showed features of osteomalacia with a very low Vitamin D level of less than 20 nmol/L | *Bone studies showed features of osteomalacia with a very low Vitamin D level of less than 20 nmol/L<br> | ||
<br> | |||
'''Past Medical History:''' | '''Past Medical History:''' | ||
Line 94: | Line 85: | ||
*Previously diagnosed with solitary plasmacytoma in 2001, which then progressed to smoldering myeloma in 2004 | *Previously diagnosed with solitary plasmacytoma in 2001, which then progressed to smoldering myeloma in 2004 | ||
*2007 the indolent version of his myeloma transformed to a more aggressive form of myeloma with non-specific musculoskeletal chest pain, anorexia, weight loss, and tumour-lysis requiring hospital admission and plasmapheresis. | *2007 the indolent version of his myeloma transformed to a more aggressive form of myeloma with non-specific musculoskeletal chest pain, anorexia, weight loss, and tumour-lysis requiring hospital admission and plasmapheresis. | ||
*June 2010 the patient was admitted to hospital after multiple falls and zoster reactivation including ophthalmic zoster of the right first and second trigeminal branches. | *June 2010 the patient was admitted to hospital after multiple falls and zoster reactivation including ophthalmic zoster of the right first and second trigeminal branches.<br> | ||
<br> | |||
'''Intervention: '''Physical Therapy | '''Intervention: '''Physical Therapy | ||
'''Co-intervention: '''Received 3,000 nmol/L daily of Vitamin D supplementation | '''Co-intervention: '''Received 3,000 nmol/L daily of Vitamin D supplementation<br> '''Outcomes: 4 months later''' | ||
<br> '''Outcomes: 4 months later''' | |||
*Significant decrease in his generalized musculoskeletal pain | *Significant decrease in his generalized musculoskeletal pain |
Revision as of 19:50, 28 March 2013
Original Editors -Nicole Hess & Shannon McMullen from Bellarmine University's Pathophysiology of Complex Patient Problems project.
Lead Editors - Your name will be added here if you are a lead editor on this page. Read more.
Definition/Description[edit | edit source]
add text here
Prevalence[edit | edit source]
add text here
Characteristics/Clinical Presentation[edit | edit source]
add text here
Associated Co-morbidities[edit | edit source]
add text here
Medications[edit | edit source]
add text here
Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
add text here
Etiology/Causes[edit | edit source]
add text here
Systemic Involvement[edit | edit source]
add text here
Medical Management (current best evidence)[edit | edit source]
add text here
Physical Therapy Management (current best evidence)[edit | edit source]
add text here
Alternative/Holistic Management (current best evidence)[edit | edit source]
add text here
Differential Diagnosis[edit | edit source]
add text here
Case Reports/ Case Studies[edit | edit source]
Case Report #1 ===
Authors:
Clement Z, Ashford M, and Sivakumaran
Abstract:
- Vitamin D deficiency is extremely common in multiple myeloma, and it represents a surrogate for clinical multiple myeloma disease status. Patients may complain of dull, persistent, generalized musculoskeletal aches and pains with fatigue or decrease in muscle strength.
- This case highlights that vitamin D deficiency is common in patients with multiple myeloma, and can cause generalized musculoskeletal pain and increase the risk of falls, yet it often goes unrecognized. In patients with non-specific musculoskeletal pain, and inadequate sun-exposure medical practitioners must have a high index of suspicion for vitamin D deficiency.
Patient Characteristics:
- 63 year old man with multiple myeloma
- Current reactivation of herpes zoster
Subjective: Chief complaints include:
- Generalized weakness
- Nonspecific musculoskeletal pain
- Reported multiple falls
Examination:
- Pale presentation with a depressed affect
- Resting tremor, generalized bony tenderness, worse on movement and weight bearing
- Muscle weakness
- Waddling gait
- Bone studies showed features of osteomalacia with a very low Vitamin D level of less than 20 nmol/L
Past Medical History:
- Previously diagnosed with solitary plasmacytoma in 2001, which then progressed to smoldering myeloma in 2004
- 2007 the indolent version of his myeloma transformed to a more aggressive form of myeloma with non-specific musculoskeletal chest pain, anorexia, weight loss, and tumour-lysis requiring hospital admission and plasmapheresis.
- June 2010 the patient was admitted to hospital after multiple falls and zoster reactivation including ophthalmic zoster of the right first and second trigeminal branches.
Intervention: Physical Therapy
Co-intervention: Received 3,000 nmol/L daily of Vitamin D supplementation
Outcomes: 4 months later
- Significant decrease in his generalized musculoskeletal pain
- Bloods showed a normalized level of Vitamin D of 109 nmol/L
- Decrease in alkaline phosphatase to 182 U/L
- Currently undergoing palliative rehabilitation.
[View full article at www.najms.org/article.asp][1]
add links to case studies here (case studies should be added on new pages using the case study template)
Resources
[edit | edit source]
add appropriate resources here
Recent Related Research (from Pubmed)[edit | edit source]
see tutorial on Adding PubMed Feed
Failed to load RSS feed from http://eutils.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1NGmwZeh8JwVIzrKgHG1LrDm0izTr7ViJiDkSYAY2BW5hiXsx0|charset=UTF-8|short|max=10: Error parsing XML for RSS
References[edit | edit source]
- ↑ Clement Z, Ashford M, Sivakurmaran S. Vitamin D Deficiency in a Man with Multiple Myeloma. N Am J Med Sci. 2011 October; 3(10): 469–471. Available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3271427/. Accessed 28 March 2013.
Goodman C, Snyder T. Differential Diagnosis for Physical Therapist: Screening For Referral. Missouri: Saunders Elsevier; 2013.
Goodman C, Fuller K. Pathology: Implications for the Physical Therapist. 3rd ed. Missouri: Saunders Elsevier; 2009.
see adding references tutorial.