Osteomalacia due to vitamin D deficiency in 2 cases of immigrants

Background: Vitamin D deficiency in immigrant adults eventually leads to an osteomalacia syndrome with its characteristic clinical features of bone pain, muscle weakness and difficulty in walking (waddling gait). Case Report: We report on 2 female immigrants from Ethiopia and Eritrea who developed the typical clinical signs of osteomalacia such as generalized bone pain and muscle weakness. Also in osteomalacia there is a significant decrease in bone density but more relevant for diagnosis are low serum levels of 25-OH-vitamin D and as radiological features pseudofractures (Looser's zones). Bone biopsy definitely proves the diagnosis. Simple treatment with vitamin D and calcium is highly effective. Conclusion: Since there is an increasing number of immigrants into northern European countries osteomalacia should always be taken into consideration if such patients develop skeletal pain syndrome and muscle weakness.