<prompt> Answer this question truthfullyIf a patient with celiac sprue experiences diffuse bone pain, muscle weakness, and has laboratory results showing lownormal calcium, low phosphate, high PTH, and high alkaline phosphatase, what is the likely diagnosis?  <response>: <reason> The likely diagnosis for the patients symptoms and laboratory results is osteomalacia. Osteomalacia is a condition that occurs when there is a deficiency of vitamin D, which is necessary for the proper absorption and metabolism of calcium and phosphorus. Patients with celiac sprue may be at increased risk for vitamin D deficiency due to malabsorption of nutrients in the small intestine. Symptoms of osteomalacia may include bone pain, muscle weakness, and difficulty walking. Laboratory results may show lownormal calcium and low phosphate levels, as well as high levels of parathyroid hormone PTH and alkaline phosphatase. Diagnosis may involve blood tests to assess for vitamin D levels, as well as imaging studies to assess for bone abnormalities. Treatment may involve vitamin D and calcium supplements, as well as addressing the underlying cause of the vitamin D deficiency. 