Burosumab in tumor-induced osteomalacia: A case report.

Joint, Bone, Spine : Revue Du Rhumatisme
Alvin Lee DayKenneth G Saag

Abstract

Tumor-induced osteomalacia is a rare cause of acquired hypophosphatemia due to the paraneoplastic overproduction of fibroblast growth factor-23. Unlike many causes of osteomalacia, tumor-induced osteomalacia is curable by resection of the offending tumor. If a patient has a tumor that is unidentifiable, unresectable, or makes the decision to forgo surgery, medical treatment is recommended. Burosumab (KRN23) is a fully human monoclonal antibody against fibroblast growth factor-23 that was recently approved for the treatment of X-linked hypophosphatemia. We present a case of tumor-induced osteomalacia due to two somatostatin receptor avid meningiomas. The patient initially was wheelchair bound due to symptoms of diffuse bone and muscle pain with recurrent traumatic and nontraumatic fractures. Serum phosphate was 1.8mg/dL (reference range: 2.4-5.0mg/dL) with no other laboratory or historical cause. Workup revealed two widely separated intracranial meningiomas with typical magnetic resonance imaging characteristics. The duplicity of tumors precluded safe surgery and the potential delay in, or lack of, efficacy using radiosurgery prompted the treatment team to opt for medical treatment. Burosumab was initiated resulting in improveme...Continue Reading

Citations

Jun 4, 2020·The New England Journal of Medicine·Nicholas YozampJoseph Loscalzo
Jul 14, 2020·Clinical Diabetes and Endocrinology·Debbie W ChenPalak U Choksi
Jan 30, 2020·Wiener medizinische Wochenschrift·Adalbert RaimannRudolf Ganger
Sep 24, 2020·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Yasuo ImanishiSeiji Fukumoto
Dec 19, 2020·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Suzanne M Jan de BeurThomas O Carpenter
Jun 21, 2021·Bone·Maria Luisa BrandiLothar Seefried

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