title: [A case of iron and aluminum related osteomalacia in a long-term hemodialysis patient].
abstract: A 32-year-old woman undergoing hemodialysis for 12 years was referred because of systemic bone pain and pathological fracture of ribs and right tibia. Her serum ferritin was 4800 ng/ml, liver CT level was extremely high and skeletal scintigram by 99 m-Tc-MDP revealed high activity of soft tissue. Her serum aluminum was elevated more than 20 micrograms/dl by deferoxamine infusion test. Osteomalacia and positive staining of both aluminum and iron was observed by bone biopsy examination. After treatment with deferoxamine as a chelating agent of iron and aluminum, bone pain was relieved and second bone biopsy specimen revealed improvement of osteomalacia. But serum aluminum was slightly reduced and serum ferritin level and liver CT level were unchanged.
authors.affiliation: Institute of Clinical Medicine, University of Tsukuba.
authors.forename: K
authors.initials: K
authors.lastname: Yamagata
authors.forename: M
authors.initials: M
authors.lastname: Kobayashi
authors.forename: A
authors.initials: A
authors.lastname: Koyama
authors.forename: M
authors.initials: M
authors.lastname: Narita
authors.forename: H
authors.initials: H
authors.lastname: Amagai
authors.forename: A
authors.initials: A
authors.lastname: Ohno
authors.forename: S
authors.initials: S
authors.lastname: Yoshikawa
mesh_terms: D000328:Adult; D000535:Aluminum / Q000378:metabolism*; D003676:Deferoxamine / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D007262:Infusions, Intravenous; D007501:Iron / Q000378:metabolism*; D010018:Osteomalacia / Q000209:etiology* / Q000378:metabolism; D006435:Renal Dialysis / Q000009:adverse effects*; D012709:Serum Albumin / Q000378:metabolism
chemical_list: D012709:Serum Albumin; D005293:Ferritins; D000535:Aluminum; D007501:Iron; D003676:Deferoxamine