Rare Case of Vitamin D Deficiency without Elevation of Alkaline Phosphatase

Elevated serum Alkaline phosphatase acts as screening marker of vitamin D deficiency. Failure of its elevation might result in misdiagnosis. Estimation of both radiological findings and serum Alkaline Phosphatase helps in early recognition of metabolic bone diseases. One of the rare differentials that can be considered with normal alkaline phosphatase and with low vitamin D levels being hypophosphatasia, which is a rare genetic disorder characterized by abnormal development of bone and teeth.