Marked increase in bone mineral density with oral phosphate and calcitriol in tumour-induced osteomalacia.
BMJ Case Rep
; 16(12)2023 Dec 06.
Article
in En
| MEDLINE
| ID: mdl-38056928
ABSTRACT
Patients with osteomalacia have a low bone mineral density (BMD) and are often misdiagnosed as osteoporosis. A marked increase in BMD is noticed following successful treatment of osteomalacia. The biochemical hallmark of tumour-induced osteomalacia (TIO) is hypophosphatemia. Patients with TIO often have severe hypophosphatemic osteomalacia and dual-energy X-ray absorptiometry may demonstrate low BMD. Surgical removal of the phosphatonin-secreting lesion restores serum phosphate, corrects osteomalacia and is associated with a dramatic increase in BMD. We report two patients with TIO and low BMD, who were treated with oral phosphate and calcitriol supplementation. The percentage increase in BMD at 33 months was as high as 94.3% in areas with the lowest BMD at baseline. The BMD at 33 months was higher than the +2SD of the population-specific reference ranges, a finding not reported in surgically treated patients with TIO. An intermittent rise in parathyroid hormone following oral phosphate supplementation might have resulted in such findings.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Osteomalacia
/
Hypophosphatemia
Limits:
Humans
Language:
En
Journal:
BMJ Case Rep
Year:
2023
Document type:
Article
Affiliation country:
India