[Long-term follow-up study of bone mineral density in a patient with adult idiopathic Fanconi syndrome].
A 64-year-old woman complaining of severe lumbar pain was admitted to our hospital because of the finding of pre-existing mitral valve regurgitation on examination. Laboratory data revealed the proximal type of renal tubular acidosis, renal glucosuria, phosphaturia, generalized aminoaciduria and low-molecular-weight proteinuria. She did not have any cause of these tubular dysfunctions, and was diagnosed as adult idiopathic Fanconi syndrome. Dual energy X-ray absorptiometry (DEXA) revealed a reduction of bone mineral density in the lumbar spine to about 65% of the age-and gender-matched control value. Alkali agents (sodium citrate and potassium citrate), calcium lactate and 1 alpha-hydroxyvitamin D3 were administered. Bone mineral density estimated with DEXA improved with a reduction of serum alkali phosphate and disappearance of lumbar pain, and was restored to 82% of the age-and gender-matched control value after about 30 months of treatment. DEXA is useful for the long-term follow-up study of bone mineral density in a patient with Fanconi syndrome.
Uchida
K
K
Second Department of Internal Medicine, School of Medicine, Faculty of Medicine, Kagawa Medical University, Japan.
Yuasa
S
S
Takahashi
N
N
Shoji
T
T
Kiyomoto
H
H
Fujioka
H
H
Hashimoto
M
M
Fujita
Y
Y
Matsuo
H
H
D015502:Absorptiometry, Photon; D000141:Acidosis, Renal Tubular / Q000150:complications / Q000503:physiopathology; D015519:Bone Density; D005198:Fanconi Syndrome / Q000150:complications / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006887:Hydroxycholecalciferols / Q000008:administration & dosage; D008875:Middle Aged; D010018:Osteomalacia / Q000188:drug therapy / Q000209:etiology
D006887:Hydroxycholecalciferols; C008088:alfacalcidol