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2016 ; 5
(1
): 1904
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Dramatic mitigation of bone pain after phosphorus replacement therapy in a
subject with FGF23-related hypophosphatemic osteomalacia
#MMPMID27867811
Tatsumi F
; Horiya M
; Tanabe A
; Nishioka M
; Fushimi Y
; Sanada J
; Hirata Y
; Irie S
; Kinoshita T
; Kamei S
; Shimoda M
; Mune T
; Kaku K
; Kaneto H
Springerplus
2016[]; 5
(1
): 1904
PMID27867811
show ga
INTRODUCTION: Fibroblast growth factor 23 (FGF23) is secreted from bone and
suppresses the absorption of phosphorus in renal proximal tubule and in
intestinal tract. Therefore, the increase of serum FGF23 levels leads to
hypophosphatemic situations. Tumor-induced osteomalacia is often induced by
various tumors, but it is often difficult to identify the localization of tumor,
because most of the FGF23-producing tumors are small and could be observed in any
part of the body. CASE DESCRIPTION: Here we report a case of elderly female
subject with FGF23-related hypophosphatemic osteomalacia who repeatedly
experienced severe bone pain and fragility fracture in various parts of the body.
Although we failed to identify the localization of tumor in this subject even
with various examination, after starting phosphorus replacement therapy with
relatively small amounts of calcium phosphate (1.5 g/day) (phosphorus content:
270 mg), hypophosphatemia was ameliorated and repeated bone pain was dramatically
mitigated without any surgical operation. DISCUSSION AND EVALUATION: Even when we
fail to identify the localization of tumor in subjects with FGF23-related
hypophosphatemic osteomalacia, phosphorus replacement therapy for
hypophosphatemia could reduce the bone pain. CONCLUSIONS: We should be aware of
the possibility that phosphorus replacement therapy exert marked beneficial
effects for the reduction of bone pain in subjects with FGF23-related
hypophosphatemic osteomalacia even when we fail to identify tumor localization.