title: A familial disorder with low bone density and renal phosphate wasting.
abstract: Hereditary forms of renal phosphate wasting have been studied thoroughly in the past years. X-linked Hypophosphatemic rickets (XLH), autosomal dominant hypophosphatemic rickets/osteomalacia (ADHR) and autosomal recessive hypophosphatemic rickets (ARHR) are known genetic disorders in which a disturbance of phosphatonins is a causative factor in the pathogenesis. We describe a comparable but yet undescribed disorder in a family in which a 53 year old man presented with a spontaneous fracture after suffering for years with severe fatigue and musculoskeletal pains. A low serum phosphate was discovered. The two subsequent generations of this family developed the same symptoms but at an earlier age. Almost all family members have been investigated and the majority appears to have low bone density and/or renal phosphate wasting and/or low serum phosphate. Remarkably no rickets was found. No elevation of FGF23 or mutations in the gene encoding FGF23 were found. We believe this is a new familial disorder of bone metabolism and phosphate homeostasis in which a disturbance of bone modulators may play a central role.
authors.affiliation: Department of Paediatrics, Deventer Ziekenhuis, Deventer, The Netherlands.
authors.forename: I M
authors.initials: IM
authors.lastname: Grondel
authors.forename: J
authors.initials: J
authors.lastname: van der Deure
authors.forename: A L
authors.initials: AL
authors.lastname: Zanen
authors.forename: M
authors.initials: M
authors.lastname: Dogger
authors.forename: L P
authors.initials: LP
authors.lastname: van den Heuvel
mesh_terms: D000293:Adolescent; D000367:Age Factors; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000150:complications* / Q000235:genetics* / Q000378:metabolism; D005221:Fatigue / Q000209:etiology; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000235:genetics*; D050723:Fractures, Bone / Q000209:etiology; D006801:Humans; D007015:Hypophosphatemia, Familial / Q000150:complications* / Q000235:genetics* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010375:Pedigree; D055815:Young Adult
chemical_list: C000717427:FGF23 protein, human; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23