Archives of osteoporosis · 2025
Bariatric surgery: Think about osteomalacia too.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mocritcaia Anastasia, Chacur Chafik, Flórez Helena, Monegal Ana, Guañabens Núria, Peris Pilar
Аннотация
UNLABELLED: Around 9% of patients with previous bariatric surgery referred for osteoporosis treatment may have osteomalacia. Increased serum total alkaline phosphatase values should alert clinicians to this diagnosis since it requires a differential treatment approach, with some patients needing high doses of calcium or even parenteral vitamin D supplementation.
INTRODUCTION: The development of osteoporosis and fractures is a well-documented complication of bariatric surgery (BS). Nevertheless, subjects undergoing BS can also develop osteomalacia, which can be easily misdiagnosed as osteoporosis.
OBJECTIVES: To analyze the prevalence of osteomalacia and the main clinical characteristics of subjects with previous BS referred to a Rheumatology Department for osteoporosis treatment.
METHODS: This retrospective study included a cohort of 46 subjects (aged 42-77 years) with previous BS referred for osteoporosis treatment. Clinical data were obtained from a review of medical records, including the type and time since surgery, treatment with calcium and/or vitamin D, and clinical, laboratory, radiologic, and densitometric data. Osteomalacia was diagnosed by compatible bone biopsy and/or clinical criteria (two of the following: low calcium, low phosphate, elevated total alkaline phosphatase [TAP], or suggestive radiology).
RESULTS: Four out of 46 patients (8.7%) presented osteomalacia criteria; most were women (3/4) treated with malabsorptive surgery (from 4 to 13 years previously). All presented increased serum TAP and parathyroid hormone values, and most presented hypocalcemia and low vitamin D levels. Bone scan was compatible with osteomalacia in most subjects, and all subjects presented densitometric osteoporosis, with most developing fractures/pseudofractures after BS. No subject was referred to our department with clinical suspicion of osteomalacia.
CONCLUSIONS: Nearly 9% of patients with previous BS referred for osteoporosis treatment may have osteomalacia. Increased serum TAP values should alert clinicians to this diagnosis since it requires a differential treatment approach, with some patients needing high doses of calcium or even parenteral vitamin D supplementation.
INTRODUCTION: The development of osteoporosis and fractures is a well-documented complication of bariatric surgery (BS). Nevertheless, subjects undergoing BS can also develop osteomalacia, which can be easily misdiagnosed as osteoporosis.
OBJECTIVES: To analyze the prevalence of osteomalacia and the main clinical characteristics of subjects with previous BS referred to a Rheumatology Department for osteoporosis treatment.
METHODS: This retrospective study included a cohort of 46 subjects (aged 42-77 years) with previous BS referred for osteoporosis treatment. Clinical data were obtained from a review of medical records, including the type and time since surgery, treatment with calcium and/or vitamin D, and clinical, laboratory, radiologic, and densitometric data. Osteomalacia was diagnosed by compatible bone biopsy and/or clinical criteria (two of the following: low calcium, low phosphate, elevated total alkaline phosphatase [TAP], or suggestive radiology).
RESULTS: Four out of 46 patients (8.7%) presented osteomalacia criteria; most were women (3/4) treated with malabsorptive surgery (from 4 to 13 years previously). All presented increased serum TAP and parathyroid hormone values, and most presented hypocalcemia and low vitamin D levels. Bone scan was compatible with osteomalacia in most subjects, and all subjects presented densitometric osteoporosis, with most developing fractures/pseudofractures after BS. No subject was referred to our department with clinical suspicion of osteomalacia.
CONCLUSIONS: Nearly 9% of patients with previous BS referred for osteoporosis treatment may have osteomalacia. Increased serum TAP values should alert clinicians to this diagnosis since it requires a differential treatment approach, with some patients needing high doses of calcium or even parenteral vitamin D supplementation.