{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:43:28Z","timestamp":1791931408989,"version":"4.3.4"},"reference-count":33,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2014,12,2]],"date-time":"2014-12-02T00:00:00Z","timestamp":1417478400000},"content-version":"unspecified","delay-in-days":2041,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. j. neurol. sci."],"published-print":{"date-parts":[[2009,5]]},"abstract":"<jats:sec id=\"S0317167100007083_abs1\">\n\t    <jats:title>Background:<\/jats:title>\n\t    <jats:p>Osteomalacia is an uncommon cause of muscle weakness. Our objectives were to describe features of myopathy associated with Vitamin D deficiency and examine the contributing factors leading to osteomalacic myopathy in our region.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0317167100007083_abs2\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>Patients identified retrospectively for the six year period ending in December 2006 with the diagnosis of osteomalacia and\/or Vitamin D deficiency associated proximal muscle weakness were included. They were followed in three major centers in western Saudi Arabia. Clinical, biochemical, radiological, and electrophysiological findings were collected before and after Vitamin D treatment by chart review.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0317167100007083_abs3\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>Forty seven female patients aged 13-46 years (mean 23.5, SD 4.5) were included. All were veiled and covered heavily when outside the house for social and cultural reasons. Only eight (17%) had adequate varied diet with daily milk ingestion. All patients presented with progressive proximal muscle weakness lasting 6-24 months (mean 14) prior to our evaluation. The weakness was severe in six (13%) patients leading to wheel chair bound states. Associated musculoskeletal pain involving the back, hips, or lower limbs was common (66%). Osteomalcia was the referral diagnosis in only 11 patients and the remaining 36 (77%) patients were misdiagnosed. All patients had metabolic and radiological profiles suggestive of osteomalacia. Remarkable recovery was documented in all patients following oral cholecalciferol and calcium supplementation.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0317167100007083_abs4\">\n\t    <jats:title>Conclusions:<\/jats:title>\n\t    <jats:p>Vitamin D deficiency is an important treatable cause of osteomalacic myopathy in Saudi Arabia. The diagnosis is frequently delayed or missed. Screening for Vitamin D deficiency in patients with acquired myopathy is needed to identify this treatable disorder.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s0317167100007083","type":"journal-article","created":{"date-parts":[[2014,12,12]],"date-time":"2014-12-12T15:15:30Z","timestamp":1418397330000},"page":"336-339","source":"Crossref","is-referenced-by-count":58,"title":["Severe Proximal Myopathy with Remarkable Recovery after Vitamin D Treatment"],"prefix":"10.1017","volume":"36","author":[{"given":"Yousef A.","family":"Al-Said","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiyam S.","family":"Al-Rached","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussien A.","family":"Al-Qahtani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed M.S.","family":"Jan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2014,12,2]]},"reference":[{"key":"S0317167100007083_manual_ref-9","doi-asserted-by":"crossref","first-page":"1678","DOI":"10.1093\/ajcn\/80.6.1678S","article-title":"Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease","volume":"80","author":"Holick","year":"2004","journal-title":"Am J Clin Nutr."},{"key":"S0317167100007083_manual_ref-22","doi-asserted-by":"publisher","DOI":"10.1002\/mus.20394"},{"key":"S0317167100007083_manual_ref-33","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1097\/00003072-200005000-00003","article-title":"Hypophosphatemic osteomalacia demonstrated by Tc-99m MDP bone scan: a case report","volume":"25","author":"Kim","year":"2000","journal-title":"Clin Nucl Med."},{"key":"S0317167100007083_manual_ref-6","doi-asserted-by":"publisher","DOI":"10.1159\/000176801"},{"key":"S0317167100007083_manual_ref-13","first-page":"269","article-title":"Vitamin D: a millennium perspective","volume":"88","author":"Holick","year":"2002","journal-title":"J Cell Biochem."},{"key":"S0317167100007083_manual_ref-12","doi-asserted-by":"publisher","DOI":"10.4065\/78.12.1463"},{"key":"S0317167100007083_manual_ref-26","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.4.5727.69"},{"key":"S0317167100007083_manual_ref-19","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/BF03343702","article-title":"Sunlight exposure and Vitamin D deficiency in Turkish women","volume":"23","author":"Alagol","year":"2000","journal-title":"J Endocinol Invest."},{"key":"S0317167100007083_manual_ref-2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2990.1979.tb00628.x"},{"key":"S0317167100007083_manual_ref-16","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1089\/15246090152636523","article-title":"Vitamin D status and bone mineral density of veiled and unveiled Turkish women","volume":"10","author":"Guzel","year":"2001","journal-title":"J Women Health Gend Based Med."},{"key":"S0317167100007083_manual_ref-27","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1111\/j.1600-0404.1984.tb00806.x","article-title":"Carbamazepine and bone mineral metabolism","volume":"70","author":"Hoikka","year":"1984","journal-title":"Acta Neurol Scand."},{"key":"S0317167100007083_manual_ref-3","first-page":"238","article-title":"Osteomalacic myopathy","volume":"74","author":"Kaur","year":"1980","journal-title":"J Indian Med Assoc."},{"key":"S0317167100007083_manual_ref-17","first-page":"315","article-title":"Vitamin D deficiency in veiled Kuwaiti women","volume":"50","author":"El Sonbaty","year":"1996","journal-title":"Eur J Clin Nutr."},{"key":"S0317167100007083_manual_ref-8","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.45.675"},{"key":"S0317167100007083_manual_ref-10","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200301150-00015"},{"key":"S0317167100007083_manual_ref-21","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.61.8.1185"},{"key":"S0317167100007083_manual_ref-28","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1002\/mus.880170603","article-title":"Osteomalacic myopathy","volume":"17","author":"Russell","year":"1994","journal-title":"Muscle Nerve."},{"key":"S0317167100007083_manual_ref-34","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-89-6-966"},{"key":"S0317167100007083_manual_ref-24","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1007\/s10067-004-0977-5","article-title":"Proximal myopathy as an unusual presenting feature of celiac disease","volume":"24","author":"Kozanoglu","year":"2005","journal-title":"Clin Rheumatol."},{"key":"S0317167100007083_manual_ref-11","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/0002-9343(93)90335-M","article-title":"Noninvasive testing in the diagnosis of osteomalacia","volume":"95","author":"Bingham","year":"1993","journal-title":"Am J Med."},{"key":"S0317167100007083_manual_ref-18","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1007\/s00198-006-0069-2","article-title":"High prevalence of Vitamin D deficiency, secondary hyperparathyroidism and generalized bone pain in Turkish immigrant in Germany: identification of risk factors","volume":"17","author":"Erkal","year":"2006","journal-title":"Osteoporos Int."},{"key":"S0317167100007083_manual_ref-4","first-page":"107","article-title":"Musculoskeletal manifestations of osteomalacia","volume":"64","author":"Reginato","year":"1997","journal-title":"Rev Rhum Engl Ed."},{"key":"S0317167100007083_manual_ref-32","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/0002-9343(93)90335-M","article-title":"Noninvasive testing in the diagnosis of osteomalacia","volume":"95","author":"Bingham","year":"1993","journal-title":"Am J Med."},{"key":"S0317167100007083_manual_ref-30","doi-asserted-by":"publisher","DOI":"10.1007\/s001980200012"},{"key":"S0317167100007083_manual_ref-29","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1007\/s002230010085","article-title":"Hypovitaminosis D myopathy without biochemical signs of osteomalacic bone involvement","volume":"66","author":"Glerup","year":"2000","journal-title":"Calcif Tissue Int."},{"key":"S0317167100007083_manual_ref-25","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.1992.tb00554.x"},{"key":"S0317167100007083_manual_ref-23","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1097\/00042737-200211000-00018","article-title":"Disabling osteomalacic myopathy as the only presenting feature of celiac disease","volume":"14","author":"Byrne","year":"2002","journal-title":"Eur J Gastroenterol Hepatol."},{"key":"S0317167100007083_manual_ref-20","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2006.0089"},{"key":"S0317167100007083_manual_ref-15","first-page":"439","article-title":"Clinical and histological spectrum of osteomalacia among Asians in South London","volume":"83","author":"Finch","year":"1992","journal-title":"Q J Med."},{"key":"S0317167100007083_manual_ref-5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1975.tb01358.x"},{"key":"S0317167100007083_manual_ref-14","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198604000-00027"},{"key":"S0317167100007083_manual_ref-7","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1093\/ajcn\/38.1.129","article-title":"Sunlight and Vitamin D status in normal Saudi subjects","volume":"38","author":"Sedrani","year":"1983","journal-title":"Am J Clin Nutr."},{"key":"S0317167100007083_manual_ref-31","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1002\/mus.880170603","article-title":"Osteomalacic myopathy","volume":"17","author":"Russell","year":"1994","journal-title":"Muscle Nerve."}],"container-title":["Canadian Journal of Neurological Sciences \/ Journal Canadien des Sciences Neurologiques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0317167100007083","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T23:50:58Z","timestamp":1750463458000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0317167100007083\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,5]]},"references-count":33,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2009,7]]}},"alternative-id":["S0317167100007083"],"URL":"https:\/\/doi.org\/10.1017\/s0317167100007083","relation":{},"ISSN":["0317-1671","2057-0155"],"issn-type":[{"value":"0317-1671","type":"print"},{"value":"2057-0155","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,5]]}}}