A case of generalized disability and muscle weakness.

Ghofran is 42 year old female who presented with fatigue, joint pain, proximal muscle weakness and agonising whole body pain. Nothing remarkable on her examination. Upon investigation for connective tissue disease everything was normal. Her vitamin D level was severely lowered. Again her related metabolic profile was normal and no obvious cause for the vitamin D deficiency. I commenced her on high dose ergocalciferol. On follow up visit one month later a failure to increase vitamin D is noticed and the patient still suffering. I am eager to read your kind responses to this dilemma case and your suggestions about next step.
Source: Doc2Doc BMJ Cardiology - Category: Cardiology Authors: Source Type: forums