[Drug-induced osteomalacia].
In our country, calcium- or phosphate-deficient rickets/osteomalacia due to malnutrition are scarcely reported. However, osteomalacia induced by drugs, such as anti-epileptics, etidronate and saccharated ferric oxide (SFO) is occasionally reported. When SFO is repeatedly injected to patients with iron-deficient anemia for a prolonged period, a tiny amount of SFO is excreted into renal tubules, where it exerts toxic effects on renal phosphate reabsorption and 1alpha-hydroxylase activity, leading to hypophosphatemic osteomalacia. Furthermore, Fe accumulates on the calcification front, resulting in impairment of bone formation. Although the SFO-induced osteomalacia is reversible, SFO should be used according to instructions of the package inserts, since it is a very effective parental agent for patients with iron-deficient anemia.
Sato
Kanji
K
Tokyo Women's Medical University, Institute of Clinical Endocrinology.
D000927:Anticonvulsants / Q000009:adverse effects; D012968:Etidronic Acid / Q000009:adverse effects; D005290:Ferric Compounds / Q000009:adverse effects*; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid; D006397:Hematinics / Q000009:adverse effects*; D006801:Humans; D010018:Osteomalacia / Q000139:chemically induced*
D000927:Anticonvulsants; D005290:Ferric Compounds; D006397:Hematinics; D000077605:Ferric Oxide, Saccharated; D012968:Etidronic Acid; D005937:Glucaric Acid