Oral 25-hydroxyvitain D3 in treatment of osteomalacia associated with ileal resection and cholestyramine therapy

Gastroenterology. 1978 May;74(5 Pt 1):900-2.


Severe histological osteomalacia developed in a woman with Crohn's disease 2 years after ileal resection and the start of cholestyramine therapy. Treatment with oral 25-hydroxyvitamin D3, 50 microgram daily, produced marked biochemical, radiological, and histological improvement after 6 months. It is suggested that cholestyramine, by reducing vitamin D absorption, precipitated the rapid development of osteomalacia in this patient. This case report emphasizes the importance of routine vitamin D supplementation in all patients on long term cholestyramine therapy, and indicates that even in patients with small intestinal disease or resection, oral preparations of vitamin D or its metabolities and analogues may be effective.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Alkaline Phosphatase / blood
  • Calcium / blood
  • Cholestyramine Resin / adverse effects*
  • Cholestyramine Resin / therapeutic use
  • Diarrhea / drug therapy
  • Female
  • Humans
  • Hydroxycholecalciferols / administration & dosage*
  • Hydroxycholecalciferols / therapeutic use
  • Ileum / surgery*
  • Middle Aged
  • Osteomalacia / chemically induced
  • Osteomalacia / drug therapy*
  • Osteomalacia / etiology
  • Phosphates / blood
  • Postoperative Complications*


  • Hydroxycholecalciferols
  • Phosphates
  • Cholestyramine Resin
  • Alkaline Phosphatase
  • Calcium