Hypophosphatemia: the common denominator of all rickets.
Rickets is a disease of the hypertrophic chondrocytes in the growth plate and is caused by hypophosphatemia-a derived defect in terminal chondrocyte apoptosis. This highlights the critical role of phosphorous in cartilage and bone metabolism. This review shows the role of phosphorous metabolism, transport and function in maintaining phosphorous supply to the growth plate, bone osteoblast and the kidney. Given that phosphorous is the common denominator of all rickets, this review proposes a new classification for the differential diagnosis of rickets, which is based on the mechanisms leading to hypophosphatemia-high PTH activity, high FGF23 activity or renal phosphaturia.
Tiosano
Dov
D
Meyer Children's Hospital, Rambam Medical Center, POB 9602, 31096, Haifa, Israel. d_tiosano@rambam.health.gov.il
Hochberg
Ze'ev
Z
D000818:Animals; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood / Q000378:metabolism; D006801:Humans; D017674:Hypophosphatemia / Q000150:complications* / Q000378:metabolism; D007674:Kidney Diseases / Q000150:complications / Q000378:metabolism; D008954:Models, Biological; D010281:Parathyroid Hormone / Q000097:blood / Q000378:metabolism; D010710:Phosphates / Q000097:blood / Q000378:metabolism; D012279:Rickets / Q000145:classification / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism
C000717427:FGF23 protein, human; D010281:Parathyroid Hormone; D010710:Phosphates; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23