osteomaláciában

Osteomalácia is a metabolic bone disease characterized by inadequate mineralization of osteoid, the unmineralized bone matrix. This leads to soft bones that are prone to fractures. In children, the equivalent condition is called rickets. The primary cause of osteomalácia is a deficiency in vitamin D, which is crucial for calcium and phosphate absorption in the intestines. Other contributing factors can include insufficient dietary intake of calcium or phosphate, chronic kidney disease which impairs vitamin D activation, malabsorption syndromes like celiac disease or Crohn's disease, and certain medications that interfere with vitamin D metabolism.

Symptoms of osteomalácia can be varied and often develop gradually. Common complaints include generalized bone pain, particularly in the hips, lower back, and legs, which may worsen with weight-bearing. Muscle weakness, especially in the proximal muscles of the thighs and shoulders, can lead to difficulty rising from a chair or climbing stairs. Patients may also experience fatigue and, in more severe cases, fractures that occur with minimal trauma, such as stress fractures.

Diagnosis typically involves a combination of clinical assessment, blood tests, and imaging. Blood tests will usually show low levels of vitamin D (25-hydroxyvitamin D), low calcium, low phosphate, and elevated alkaline phosphatase, an enzyme released by bone-building cells. X-rays may reveal characteristic Looser zones, which are pseudo-fractures or radiolucent lines in the bone. A bone biopsy is the definitive diagnostic tool but is rarely performed.

Treatment focuses on correcting the underlying deficiency. This primarily involves vitamin D supplementation, often in high doses initially, along with calcium and phosphate supplements if needed. Addressing any underlying medical conditions contributing to the malabsorption or impaired vitamin D metabolism is also essential. With appropriate treatment, bone mineralization can be restored, and symptoms typically improve.