Severe vitamin D deficiency in Hawai'i: a case report.

Severe vitamin D deficiency would appear unlikely to occur in Hawai'i, which has abundant year-round sun exposure. This case report of a woman with no obvious risk factors for vitamin D deficiency who was found to have severe vitamin D deficiency and coexisting primary hyperparathyroidism should alert health care providers to be more aware of vitamin D deficiency in Hawai'i.