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| ==Overview== | | ==Overview== |
| Mild to moderate vitamin D deficiency could be asymptomatic in children and adults. However, severe vitamin D deficiency may be presented as rickets in children and osteomalacia in adults. Some nonspecific associated symptoms including muscle weakness or bone pain may be seen. <ref name="pmid19835345">{{cite journal |vauthors=Bordelon P, Ghetu MV, Langan RC |title=Recognition and management of vitamin D deficiency |journal=Am Fam Physician |volume=80 |issue=8 |pages=841–6 |year=2009 |pmid=19835345 |doi= |url=http://www.aafp.org/link_out?pmid=19835345}}</ref> <ref name="LeFevre2015">{{cite journal|last1=LeFevre|first1=Michael L.|title=Screening for Vitamin D Deficiency in Adults: U.S. Preventive Services Task Force Recommendation Statement|journal=Annals of Internal Medicine|volume=162|issue=2|year=2015|pages=133|issn=0003-4819|doi=10.7326/M14-2450}}</ref>
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| ==History==
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| Obtaining the history from a patient with vitamin D deficiency is helpful in determining the cause, treatment and prevention strategy. It is essential to question about risk factors that predispose individuals to this condition. Main focuses on taking history are outlined below: <ref name="pmid18400738">{{cite journal |vauthors=Holick MF, Chen TC |title=Vitamin D deficiency: a worldwide problem with health consequences |journal=Am. J. Clin. Nutr. |volume=87 |issue=4 |pages=1080S–6S |year=2008 |pmid=18400738 |doi= |url=http://www.ajcn.org/cgi/pmidlookup?view=long&pmid=18400738}}</ref> <ref name="Holick2006">{{cite journal|last1=Holick|first1=M. F.|title=Resurrection of vitamin D deficiency and rickets|journal=Journal of Clinical Investigation|volume=116|issue=8|year=2006|pages=2062–2072|issn=0021-9738|doi=10.1172/JCI29449}}</ref>
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| * Onset, duration, and progression of symptoms
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| * Associated symptoms (muscle and bone pain)
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| * History of fall
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| * Malabsorption symptoms (diarrhea, weight loss, growth retardation)
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| * Medications
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| * Diet
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| * Lifestyle
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| * History of sun exposure
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| * Geographic area
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| * Maternal history
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| * Exclusive breast-feeding
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| ==Symptoms==
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| * Growth retardation <ref name="pmid18400738">{{cite journal |vauthors=Holick MF, Chen TC |title=Vitamin D deficiency: a worldwide problem with health consequences |journal=Am. J. Clin. Nutr. |volume=87 |issue=4 |pages=1080S–6S |year=2008 |pmid=18400738 |doi= |url=http://www.ajcn.org/cgi/pmidlookup?view=long&pmid=18400738}}</ref>
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| * Osteopenia <ref name="pmid18400738">{{cite journal |vauthors=Holick MF, Chen TC |title=Vitamin D deficiency: a worldwide problem with health consequences |journal=Am. J. Clin. Nutr. |volume=87 |issue=4 |pages=1080S–6S |year=2008 |pmid=18400738 |doi= |url=http://www.ajcn.org/cgi/pmidlookup?view=long&pmid=18400738}}</ref>
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| * Osteomalacia
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| * Rickets <ref name="Holick2006">{{cite journal|last1=Holick|first1=M. F.|title=Resurrection of vitamin D deficiency and rickets|journal=Journal of Clinical Investigation|volume=116|issue=8|year=2006|pages=2062–2072|issn=0021-9738|doi=10.1172/JCI29449}}</ref>
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| ==Associated symptoms== | | ==Physical examination== |
| * Nonspecific musculoskeletal pain <ref name="pmid14661675">{{cite journal |vauthors=Plotnikoff GA, Quigley JM |title=Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain |journal=Mayo Clin. Proc. |volume=78 |issue=12 |pages=1463–70 |year=2003 |pmid=14661675 |doi=10.4065/78.12.1463 |url=https://linkinghub.elsevier.com/retrieve/pii/S0025-6196(11)62742-0}}</ref>
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| * Muscle weakness <ref name="pmid14661673">{{cite journal |vauthors=Holick MF |title=Vitamin D deficiency: what a pain it is |journal=Mayo Clin. Proc. |volume=78 |issue=12 |pages=1457–9 |year=2003 |pmid=14661673 |doi=10.4065/78.12.1457 |url=https://linkinghub.elsevier.com/retrieve/pii/S0025-6196(11)62740-7}}</ref>
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| * Symmetric low back pain <ref name="pmid19835345">{{cite journal |vauthors=Bordelon P, Ghetu MV, Langan RC |title=Recognition and management of vitamin D deficiency |journal=Am Fam Physician |volume=80 |issue=8 |pages=841–6 |year=2009 |pmid=19835345 |doi= |url=http://www.aafp.org/link_out?pmid=19835345}}</ref> <ref name="HicksShardell2008">{{cite journal|last1=Hicks|first1=Gregory E.|last2=Shardell|first2=Michelle|last3=Miller|first3=Ram R.|last4=Bandinelli|first4=Stefania|last5=Guralnik|first5=Jack|last6=Cherubini|first6=Antonio|last7=Lauretani|first7=Fulvio|last8=Ferrucci|first8=Luigi|title=Associations Between Vitamin D Status and Pain in Older Adults: The Invecchiare in Chianti Study|journal=Journal of the American Geriatrics Society|volume=56|issue=5|year=2008|pages=785–791|issn=00028614|doi=10.1111/j.1532-5415.2008.01644.x}}</ref>
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| * Throbbing bone pain
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| * Fall <ref name="HolickBinkley2011">{{cite journal|last1=Holick|first1=Michael F.|last2=Binkley|first2=Neil C.|last3=Bischoff-Ferrari|first3=Heike A.|last4=Gordon|first4=Catherine M.|last5=Hanley|first5=David A.|last6=Heaney|first6=Robert P.|last7=Murad|first7=M. Hassan|last8=Weaver|first8=Connie M.|title=Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline|journal=The Journal of Clinical Endocrinology & Metabolism|volume=96|issue=7|year=2011|pages=1911–1930|issn=0021-972X|doi=10.1210/jc.2011-0385}}</ref>
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| * Fracture <ref name="pmid18400738">{{cite journal |vauthors=Holick MF, Chen TC |title=Vitamin D deficiency: a worldwide problem with health consequences |journal=Am. J. Clin. Nutr. |volume=87 |issue=4 |pages=1080S–6S |year=2008 |pmid=18400738 |doi= |url=http://www.ajcn.org/cgi/pmidlookup?view=long&pmid=18400738}}</ref>
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| * Difficulty walking
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| ==References== | | ==References== |