Positive octreotide scintigraphy and determination of lanreotide activity in Paget's disease of bone associated with phosphate diabetes: a case report.
A patient with Paget's disease developed phosphate diabetes (phosphate: 1.6 mg/dl (2.5-4.4 mg/dl), with 29 ml/min phosphate clearance (Nl<15ml/min) and a 65% phosphate reabsorption rate (Nl>85%). As previously demonstrated in tumor-induced osteomalacia, we hypothesized that osteoblasts might manifest somatostatin receptor activity. The patient underwent an octreotide scan which demonstrated increased uptake localized in affected bone. Under lanreotide treatment (40 mg i.m.), the patient's bone pain improved with a concomitant decrease in phosphate alkaline level. Phosphate clearance and tubular readsorption rate of phosphate did not change significantly. We reviewed previously reported cases of associated Paget's bone disease and phosphate diabetes.
Department of General Internal Medicine, R.H.M.S. Site de Baudour, 136, rue Louis Caty, 7331 Baudour, Belgium. vandemergel.x@infonie.be
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D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D002118:Calcium / Q000097:blood; D005269:Femur; D006801:Humans; D007015:Hypophosphatemia, Familial / Q000209:etiology*; D010001:Osteitis Deformans / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D010146:Pain; D010281:Parathyroid Hormone / Q000097:blood; D010456:Peptides, Cyclic / Q000627:therapeutic use*; D010758:Phosphorus / Q000097:blood / Q000652:urine; D011877:Radionuclide Imaging; D013004:Somatostatin / Q000031:analogs & derivatives / Q000627:therapeutic use*
D010281:Parathyroid Hormone; D010456:Peptides, Cyclic; C060347:lanreotide; D010758:Phosphorus; D013004:Somatostatin; D000469:Alkaline Phosphatase; D002118:Calcium