Tumor-induced osteomalacia.
Tumor-induced osteomalacia (TIO) is a rare paraneoplastic form of renal phosphate wasting that results in severe hypophosphatemia, a defect in vitamin D metabolism, and osteomalacia. This debilitating disorder is illustrated by the clinical presentation of a 55-year-old woman with progressive fatigue, weakness, and muscle and bone pain with fractures. After a protracted clinical course and extensive laboratory evaluation, tumor-induced osteomalacia was identified as the basis of her clinical presentation. In this article, the distinctive clinical characteristics of this syndrome, the advances in diagnosis of TIO, and new insights into the pathophysiology of this disorder are discussed.
Jan de Beur
Suzanne M
SM
Department of Medicine, Johns Hopkins University School of Medicine, and Johns Hopkins Bayview Medical Center, Baltimore, Md 21224, USA. sjandebe@jhmi.edu
D003937:Diagnosis, Differential; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000235:genetics; D006706:Homeostasis; D006801:Humans; D007668:Kidney / Q000378:metabolism; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D010018:Osteomalacia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D010257:Paraneoplastic Syndromes / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D010710:Phosphates / Q000378:metabolism; D014807:Vitamin D / Q000378:metabolism
D010710:Phosphates; D014807:Vitamin D; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23