Hypophosphatemic osteomalacia: a case simulating anklylosing spondylitis treated with anti-TNF therapy.
In this case, a young male patient diagnosed as hypophosphatemic osteomalacia and ankylosing spondylitis (AS) will be assessed by literature. A 32-year-old male patient who had been previously diagnosed as ankylosing spondylitis and hypophosphatemic osteomalacia was admitted to our clinic. In the beginning of the disease, he complained of pain on the first metatarsal bone and low back. Sacroiliac magnetic resonance (MR) images were interpreted as sacroiliitis. He was diagnosed as AS, and referred to many hospitals and received several therapies. He did not benefit from the treatment and his complaints worsened. The human leukocyte antigen (HLA) B-27 test was negative and alkaline phosphatase level was high. Old femur fractures were reported in the whole body bone scintigraphy. In addition, the patient was diagnosed with osteomalacia. While the patient was receiving vitamin D, oral phosphate, anti-tumor necrosis factor therapy was added. Patient's diagnosis was reevaluated. His final diagnosis was hypophosphatemic osteomalacia instead of ankylosing spondylitis.
Department of Physical Medicine and Rehabilitation, Ankara Numune Education and Research Hospital, Ankara, Turkey. filiz_sivas@yahoo.com.|, 380 Sok. 2/9 Çankaya,06610, Ankara, Turkey. filiz_sivas@yahoo.com.
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Sivas
Department of Physical Medicine and Rehabilitation, Ankara Numune Education and Research Hospital, Ankara, Turkey.
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Yurdakul
Department of Physical Medicine and Rehabilitation, Ankara Numune Education and Research Hospital, Ankara, Turkey.
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Durak
Department of Radiology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
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Hatipoğlu
Department of Endocrinology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
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Önal
Department of Physical Medicine and Rehabilitation, Ankara Numune Education and Research Hospital, Ankara, Turkey.
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Bodur
D000328:Adult; D006801:Humans; D017674:Hypophosphatemia / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D010018:Osteomalacia / Q000175:diagnosis / Q000188:drug therapy*; D010710:Phosphates / Q000008:administration & dosage; D013167:Spondylitis, Ankylosing; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014807:Vitamin D / Q000008:administration & dosage
D010710:Phosphates; D014409:Tumor Necrosis Factor-alpha; D014807:Vitamin D
Ankylosing spondylitis; Anti-TNF therapy; Osteomalacia