What are the causes of osteomalacia

The causes of osteomalacia are varied. To arrive at the correct diagnosis, all of the causes must be considered in the course of an appropriate workup, including: 1. Nutritional deficiency

• Vitamin D deficiency

• Calcium deficiency due to dietary chelators (e.g. phytates, oxalates)

• Phosphorus deficiency (e.g. secondary to aluminum-containing antacids)

2. Gastrointestinal malabsorption

• Intestinal disease

• Following intestinal surgery

3. Renal tubular acidosis

4. Renal tubular defects causing renal phosphate leak (e.g. vitamin-dependent rickets, type 1 and 2; Fanconi's syndrome)

5. Renal osteodystrophy

6. Miscellaneous causes

• Anticonvulsants (induce hepatic P450 microsomal system, thereby increasing degradation of vitamin D metabolites)

• Heavy metal intoxication

• Hypophosphatasia

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