A patient with osteomalacia as single presenting symptom of gluten-sensitive enteropathy.

A 59-year-old male patient presented with invalidating osteomalacia of 2.5 years' duration. The osteomalacia was caused by severe malabsorption due to gluten-sensitive enteropathy (GSE). There were no other signs or symptoms of GSE in this patient. Clinical presentation with monosymptomatic osteomalacia is very unusual. It seems that patients with GSE who undergo little exposure to the sun are at particular risk of developing overt osteomalacia. Unrecognized GSE should always be considered in the differential diagnosis of osteomalacia.