Vitamin D Deficiency: Difference between revisions
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== Systemic Involvement == | == Systemic Involvement == | ||
#Musculoskeletal System: Severe vitamin D deficiency may be associated with non-specific musculoskeletal pain, causing bone, muscle, and/or joint pain.<references /> <ref>Gerber J; Journal of the American Chiropractic Association, 2010 May-Jun; 47 (4): 6-10. (journal article) ISSN: 1081-7166. Accessed 28 March 2013</ref> | #Musculoskeletal System: Severe vitamin D deficiency may be associated with non-specific musculoskeletal pain, causing bone, muscle, and/or joint pain.<references /> <ref name="Gerber">Gerber J; Journal of the American Chiropractic Association, 2010 May-Jun; 47 (4): 6-10. (journal article) ISSN: 1081-7166. Accessed 28 March 2013</ref> | ||
== Medical Management (current best evidence) == | == Medical Management (current best evidence) == | ||
Revision as of 05:07, 29 March 2013
Original Editors -Nicole Hess & Shannon McMullen from Bellarmine University's Pathophysiology of Complex Patient Problems project.
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Definition/Description[edit | edit source]
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Prevalence[edit | edit source]
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Characteristics/Clinical Presentation[edit | edit source]
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Associated Co-morbidities[edit | edit source]
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Medications[edit | edit source]
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Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
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Etiology/Causes[edit | edit source]
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Systemic Involvement[edit | edit source]
- Musculoskeletal System: Severe vitamin D deficiency may be associated with non-specific musculoskeletal pain, causing bone, muscle, and/or joint pain. [1]
Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Alternative/Holistic Management (current best evidence)[edit | edit source]
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Differential Diagnosis[edit | edit source]
Case Reports/ Case Studies[edit | edit source]
Case Report #1 [Full article available at www.najms.org/article.asp] [4]
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.
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Resources
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
- ↑ Gerber J; Journal of the American Chiropractic Association, 2010 May-Jun; 47 (4): 6-10. (journal article) ISSN: 1081-7166. Accessed 28 March 2013
- ↑ Gerber J; Journal of the American Chiropractic Association, 2010 May-Jun; 47 (4): 6-10. (journal article) ISSN: 1081-7166. Accessed 28 March 2013
- ↑ Gerber J; Journal of the American Chiropractic Association, 2010 May-Jun; 47 (4): 6-10. (journal article) ISSN: 1081-7166. Accessed 28 March 2013
- ↑ 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.
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