| A Case of Anticonvulsant-induced Osteomalacia with Cerebellar Atrophy |
| 소뇌위축을 동반한 항경련제 유발 골연화증 1예 |
| 이창균,양인명,박철영,오승준,김덕윤,우정택,김성운,김진우,김영설,최영길 |
| 경희대학교 의과대학 내분비대사내과 |
|
|
| Abstract |
|
Osteomalacia can be precipitated in some patients who have been treated with phenytoin and phenobarbital by several factors including inadequate intake of vitamin D, reduced level of physical activity, and insufficient exposure to sunlight. Phenytoin is also known to cause cerebellar atrophy. We report a 41-year old woman who was presented with severe bone pain on the extremities and diffuse cerebellar dysfunctions, hypocalcemia, hypophosphatemia, increased activity of alkaline phosphatase, high level of parathyroid hormone, low level of calcitonin, and low levels of 25-hydroxyvitamin D and 1,25-dihydoxyvitamin D were notel, Osteocalcin level and the amount of urinary pyridinoline excretion were also increased. Bone density of spines and femurs was remarkably decreased, and bone scan showed a diffuse increased uptake. Brain MRI revealed diffuse cerebellar atrophy. Treatment with 1,25-hydroxyvitamin D and calcium improved the symptoms and biochemical parameters. This case provides a lesson that the reduced level of physical activity caused by cerebellar atrophy as well as inadequate supply of vitamin D is likely to aggravate osteomalacia in patients who should be on a long-term treatment with phenytoin. |
| Key Words:
Osteomalacia, Anticonvulsant, Cerebellar atrophy, Vitamin D |
|
PDF Links
Full text via DOI
Download Citation
