| Osteomalacia revisited : A report on 28 cases. | |
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MedLine Citation:
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PMID: 20949298 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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The aim of this study was to analyse the clinical manifestations and the most frequent causes of osteomalacia (OM) in a group of 28 patients diagnosed with this disorder during a 20-year period. OM was diagnosed by bone biopsy and/or by Bingham and Fitzpatrick criteria (two of the following: low calcium, low phosphate, elevated total alkaline phosphatase [total AP] or suggestive radiographs). Of these patients, 13 had vitamin D deficiency OM (VD-OM), 14 hypophosphatemic OM (HypoP-OM) and one had OM-associated hypophosphatasia. Deficient sun exposure and celiac disease were the most frequent etiologies of VD-OM, whereas most HypoP-OM were hereditary forms. The main clinical symptoms were polyarthralgias (89%), frequently associated with fractures (75%). Fifty seven percent had densitometric criteria of osteoporosis. Patients with VD-OM showed significantly higher total AP and PTH serum values, but lower vitamin D, serum calcium, calciuria and bone mass than patients with HypoP-OM. Conversely, HypoP-OM patients had significantly lower serum phosphate and higher phosphaturia than patients with VD-OM. Briefly, high total AP, low serum calcium and low serum phosphate were observed in 85%, 65% and 15%, respectively, of patients with VD-OM, being observed in 64%, 14% and 100%, respectively, of HypoP-OM patients. Nearly 50% of these latter showed increased FGF23 levels. In conclusion, in this study, the frequencies of HypoP-OM and VD-OM were similar. The most frequent laboratory abnormalities were increased total AP and decreased serum phosphate. A urinary calcium loss of less than 50 mg/dl was highly discriminatory for VD-OM and a serum phosphate less than 2.3 mg/dl was also high discriminatory for HypoP-OM. Low densitometric values and fractures were frequent among these patients. |
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Authors:
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Laia Gifre; Pilar Peris; Ana Monegal; Maria Jesús Martinez de Osaba; Luisa Alvarez; Núria Guañabens |
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Publication Detail:
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Type: Journal Article Date: 2010-10-15 |
Journal Detail:
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Title: Clinical rheumatology Volume: 30 ISSN: 1434-9949 ISO Abbreviation: Clin. Rheumatol. Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-04-27 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8211469 Medline TA: Clin Rheumatol Country: Germany |
Other Details:
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Languages: eng Pagination: 639-45 Citation Subset: IM |
Affiliation:
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Metabolic Bone Diseases Unit, Service of Rheumatology, Hospital Clínic, University of Barcelona, Villarroel 170, 08036, Barcelona, Spain, lgifre@clinic.ub.es. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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