{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T01:34:09Z","timestamp":1782869649189,"version":"3.54.5"},"reference-count":20,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,6,6]]},"abstract":"<jats:p>A 34-year-old Japanese woman presented with a 2-year history of generalised bone pain, muscle weakness and gait disturbance. The patient had been following a restricted diet (without fish or dairy products) and avoiding ultraviolet exposure for 8\u2005years to manage her worsening atopic dermatitis. Physical examination revealed generalised bone tenderness and bilateral symmetric proximal muscle weakness. Vitamin D-deficient osteomalacia was diagnosed based on the laboratory examination findings, which indicated high serum alkaline phosphatase, high intact parathyroid hormone, and low 25-hydroxyvitamin D levels. Her symptoms improved after oral active vitamin D and calcium administration. To the best our knowledge, this case is the first report of vitamin D-deficient osteomalacia in an adult patient due to excessive dietary restriction for managing atopic dermatitis. We emphasise the importance of increasing awareness of vitamin D deficiency as a risk factor for the development of osteomalacia, and caution against excessive avoidance of sun exposure and dietary restriction.<\/jats:p>","DOI":"10.1136\/bcr-2014-204558","type":"journal-article","created":{"date-parts":[[2014,7,4]],"date-time":"2014-07-04T06:48:18Z","timestamp":1404456498000},"page":"bcr2014204558","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Vitamin D-deficient osteomalacia due to excessive self-restrictions for atopic dermatitis"],"prefix":"10.1136","volume":"2014","author":[{"given":"Kiyoshi","family":"Shikino","sequence":"first","affiliation":[{"name":"Department of General Medicine, Chiba University Hospital, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatomi","family":"Ikusaka","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Chiba University Hospital, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Chiba University Hospital, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2014,7,4]]},"reference":[{"key":"2025082803055500000_2014.jul04_1.bcr2014204558.1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-010-1587-z"},{"key":"2025082803055500000_2014.jul04_1.bcr2014204558.2","doi-asserted-by":"publisher","DOI":"10.4065\/mcp.2010.0567"},{"key":"2025082803055500000_2014.jul04_1.bcr2014204558.3","doi-asserted-by":"crossref","first-page":"1080S","DOI":"10.1093\/ajcn\/87.4.1080S","article-title":"Vitamin D deficiency. 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