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Vitamin D Deficiency-Induced Proximal Myopathy in a Pediatric Patient During COVID-19 Lockdown: A Case Report.

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Title: Vitamin D Deficiency-Induced Proximal Myopathy in a Pediatric Patient During COVID-19 Lockdown: A Case Report.
Authors: Hazique, Mohammad1 (AUTHOR), Surana, Arihant2 (AUTHOR), Mehta, Aashna3 (AUTHOR), Huang, Helen4 (AUTHOR), Alneyadi, Surour4 (AUTHOR), Shah, Kavita5 (AUTHOR), Singh, Ajeet6 (AUTHOR), Varma, Amit7 (AUTHOR), Singh, Mahendra Pratap8 (AUTHOR), Sah, Sanjit9,10 (AUTHOR), Verma, Amogh11 (AUTHOR) amoghverma2000@gmail.com
Source: Clinical Medicine Insights: Case Reports. 2/13/2025, p1-5. 5p.
Subject Terms: *VITAMIN D deficiency, *PHOTON absorptiometry, *SUNSHINE, *FOOD consumption, *DIFFERENTIAL diagnosis, *MUSCLE diseases, *STAY-at-home orders, *MUSCLE weakness, *HYPOCALCEMIA, *PARATHYROID hormone, *CHOLECALCIFEROL, *CALCIUM, *OSTEOMALACIA, *COVID-19 pandemic, *HYPOPHOSPHATEMIA, *OBESITY, *DISEASE complications
Geographic Terms: INDIA
Abstract: Vitamin D deficiency is a significant public health concern that affects bone health and muscle function in children, especially in developing countries. The COVID-19 pandemic has intensified this issue because lockdowns have reduced sunlight exposure. We report a rare case of a 13-year-old Indian boy who developed severe proximal myopathy induced by vitamin D deficiency during the pandemic. The patient presented with generalized body aches, progressive lower limb weakness, difficulty walking, waddling gait, and a positive Gower's sign. Laboratory tests revealed severe hypovitaminosis D (25[OH]D level, 3.8 ng/ml), hypocalcemia, hypophosphatemia, elevated parathyroid hormone, and elevated alkaline phosphatase levels. Electromyography and nerve conduction study results were normal. The patient was diagnosed with vitamin D deficiency-induced proximal myopathy and osteomalacia, likely due to reduced sunlight exposure, inadequate dietary intake, and obesity. The treatment involved high-dose vitamin D supplementation, oral calcium, lifestyle modifications, and a structured physiotherapy program focusing on resistance training and functional mobility exercises. Despite biochemical normalization after 2 months, significant symptomatic improvement was achieved only after intensifying physiotherapy. By 7 months, the patient had fully recovered muscle strength, achieved normal gait, and maintained normal follow-up laboratory values. This case emphasizes the importance of considering vitamin D deficiency in children with muscle weakness during periods of limited sunlight exposure, and highlights the need for a multidisciplinary approach for effective management and full functional recovery. [ABSTRACT FROM AUTHOR]
Copyright of Clinical Medicine Insights: Case Reports is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Vitamin D Deficiency-Induced Proximal Myopathy in a Pediatric Patient During COVID-19 Lockdown: A Case Report.
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  Data: <searchLink fieldCode="AR" term="%22Hazique%2C+Mohammad%22">Hazique, Mohammad</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Surana%2C+Arihant%22">Surana, Arihant</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mehta%2C+Aashna%22">Mehta, Aashna</searchLink><relatesTo>3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Huang%2C+Helen%22">Huang, Helen</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Alneyadi%2C+Surour%22">Alneyadi, Surour</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Shah%2C+Kavita%22">Shah, Kavita</searchLink><relatesTo>5</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Singh%2C+Ajeet%22">Singh, Ajeet</searchLink><relatesTo>6</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Varma%2C+Amit%22">Varma, Amit</searchLink><relatesTo>7</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Singh%2C+Mahendra+Pratap%22">Singh, Mahendra Pratap</searchLink><relatesTo>8</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Sah%2C+Sanjit%22">Sah, Sanjit</searchLink><relatesTo>9,10</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Verma%2C+Amogh%22">Verma, Amogh</searchLink><relatesTo>11</relatesTo> (AUTHOR)<i> amoghverma2000@gmail.com</i>
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  Data: <searchLink fieldCode="DE" term="%22INDIA%22">INDIA</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: Vitamin D deficiency is a significant public health concern that affects bone health and muscle function in children, especially in developing countries. The COVID-19 pandemic has intensified this issue because lockdowns have reduced sunlight exposure. We report a rare case of a 13-year-old Indian boy who developed severe proximal myopathy induced by vitamin D deficiency during the pandemic. The patient presented with generalized body aches, progressive lower limb weakness, difficulty walking, waddling gait, and a positive Gower's sign. Laboratory tests revealed severe hypovitaminosis D (25[OH]D level, 3.8 ng/ml), hypocalcemia, hypophosphatemia, elevated parathyroid hormone, and elevated alkaline phosphatase levels. Electromyography and nerve conduction study results were normal. The patient was diagnosed with vitamin D deficiency-induced proximal myopathy and osteomalacia, likely due to reduced sunlight exposure, inadequate dietary intake, and obesity. The treatment involved high-dose vitamin D supplementation, oral calcium, lifestyle modifications, and a structured physiotherapy program focusing on resistance training and functional mobility exercises. Despite biochemical normalization after 2 months, significant symptomatic improvement was achieved only after intensifying physiotherapy. By 7 months, the patient had fully recovered muscle strength, achieved normal gait, and maintained normal follow-up laboratory values. This case emphasizes the importance of considering vitamin D deficiency in children with muscle weakness during periods of limited sunlight exposure, and highlights the need for a multidisciplinary approach for effective management and full functional recovery. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of Clinical Medicine Insights: Case Reports is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1177/11795476251320006
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      – Code: eng
        Text: English
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      – SubjectFull: INDIA
        Type: general
      – SubjectFull: VITAMIN D deficiency
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      – SubjectFull: PHOTON absorptiometry
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      – SubjectFull: SUNSHINE
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      – SubjectFull: DIFFERENTIAL diagnosis
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              Text: 2/13/2025
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