[Hypophosphatemic osteomalacia in adults].
Hypophosphataemic osteomalacia occurred in a 38-year-old woman. The leading clinical symptom was severe bone pain. X-ray studies demonstrated fractures of the iliac crest and pubic and ischiadic bone, as well as Looser's zones and demineralization of the skeleton. Computerized densitometry of the bone revealed a 31% reduction of hydroxyapatite. Histological evaluation showed nearly absence of osteoclasts and extensive demineralisation of the bone. Hypophosphataemia (0.48 mmol/l), increased urinary phosphate clearance (36 ml/min), reduced renal-tubular reabsorption for phosphate (73%) and increased alkaline phosphatase (355 U/l) were present. Parathyroid hormone and 1,25-dihydroxyvitamin D were normal. No inborn errors, disturbances of the calcium metabolism or paraneoplastic signs could be detected. Defective renal tubular reabsorption of phosphate is likely to be the underlying cause of the disease. Phosphate supplementation and intermittent vitamin D administration remains the therapy of choice.
Löhr-Schwaab
S
S
Abteilung Innere Medizin II der Medizinischen Klinik und Poliklinik, Universität Freiburg.
Wanner
C
C
Reinbold
W D
WD
Schümichen
C
C
Schölmerich
J
J
Schaefer
H E
HE
Gerok
W
W
D000328:Adult; D000367:Age Factors; D002117:Calcitriol / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007684:Kidney Tubules / Q000378:metabolism; D010018:Osteomalacia / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D010710:Phosphates / Q000097:blood* / Q000378:metabolism / Q000627:therapeutic use; D011877:Radionuclide Imaging
D010710:Phosphates; D002117:Calcitriol
Hypophosphatämische Osteomalazie im Erwachsenenalter.