低磷血症
骨软化症
成纤维细胞生长因子23
医学
浪费的
骨痛
肌肉无力
病理
内科学
外科
骨质疏松症
钙
甲状旁腺激素
作者
Mathilde M. Bruins Slot-Steenks,Neveen A. T. Hamdy,Michiel A. J. van de Sande,Dennis Vriens,Arjen H.G. Cleven,Natasha M. Appelman‐Dijkstra
出处
期刊:Endocrine
[Springer Nature]
日期:2016-10-05
卷期号:54 (3): 642-647
被引量:8
标识
DOI:10.1007/s12020-016-1092-5
摘要
Tumor-induced osteomalacia is a rare acquired metabolic bone disorder characterized by isolated renal phosphate wasting due to abnormal tumor production of fibroblast growth factor 23. We report the case of a 59 year old woman referred to our department with a long history of progressive diffuse muscle weakness and pain, generalized bone pains and multiple insufficiency fractures of heels, ankles and hips due to a hypophosphatemic osteomalacia. A fibroblast growth factor 23-producing phosphaturic mesenchymal tumor localized in the left quadriceps femoris muscle was identified 7 years after onset of symptoms. Excision of the tumor resulted in normalization of serum phosphate and fibroblast growth factor 23 levels and in complete resolution of the clinical picture with disappearance of all musculoskeletal symptoms. This case illustrates the diagnostic difficulties in establishing a diagnosis tumor-induced osteomalacia and in identifying the responsible tumor. Our case underscores the clinical need to investigate all patients with persistent musculoskeletal symptoms for hypophosphatemia. A systematic approach is of pivotal importance because early recognition and treatment of the metabolic abnormality can prevent deleterious effects of osteomalacia on the skeleton.
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