Abstract
Introduction: Vitamin D deficiency resulting in a limb-girdle muscle weakness was diagnosed in
three veiled immigrant teenage girls.
Patients: Three girls had a progressive muscle weakness and pain during a period varying from
6 months to two years. On examination limb girdle muscle weakness, predominantly of
the lower extremities, without other neurological abnormalities was found. Serum examination
showed a decreased level of vitamin D and phosphate and an increased alkaline phosphatase,
and in two girls decreased calcium and increased parathyroid hormone levels were found.
After supplementation with vitamin D, the pain subsided and muscle strength increased
within weeks. Serum examination of the female relatives revealed eight persons with
hypovitaminosis D, without any complaints.
Conclusions: Vitamin D deficiency can result in a limb-girdle myopathy in veiled immigrant teenagers
in the Netherlands. Vitamin D supplementation leads to rapid recovery of the muscle
strength. The female relatives of these patients should be examined too.
Key words
Myopathy - vitamin D - immigrant - veiled
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M. D. J. C. van der Heyden
Department of Paediatric Neurology
University Medical Centre Nijmegen
P.O. Box 9101
6500 HB Nijmegen
The Netherlands
eMail: J.vanderHeyden@cukz.umcn.nl
