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01.12.2011 | Case report | Ausgabe 1/2011 Open Access

Journal of Medical Case Reports 1/2011

Proximal myopathy in lacto-vegetarian Asian patients responding to Vitamin D and calcium supplement therapy - two case reports and review of the literature

Journal of Medical Case Reports > Ausgabe 1/2011
Hood Thabit, Maurice Barry, Seamus Sreenan, Diarmuid Smith
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

HT was responsible for data analysis, the literature search and preparation of the manuscript. MB participated in the data analysis and contributed in the preparation of the manuscript. SS and DS supervised the study and edited the manuscript. All authors have read and approved the final manuscript.



Severe proximal myopathy can occasionally be the first presenting complaint of patients with osteomalacia. This may lead to investigations and misdiagnosis of a neuromuscular disease, rather than a metabolic bone disease.

Case presentations

We present here two cases of severe proximal myopathy in patients who were both of South Asian origin and lacto-vegetarians: a 31-year-old Indian man and a 34-year-old Indian woman. In both cases, their clinical symptoms fully resolved following vitamin D and calcium replacement therapy. These patients were at risk of osteomalacia due to their dietary intake and ethnicity. The role of dietary intake and sunlight exposure in the development of osteomalacia in certain ethnic groups living in Western Europe is reviewed here.


These two cases emphasize the importance of recognizing osteomalacia in at-risk individuals, as the condition is reversible and easily treated with vitamin D and calcium supplementation. It may also help avoid prolonged and unnecessary investigations of these patients.

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