PMID: 16628288Apr 22, 2006Paper

Hyperparathyroidism associated with hypophosphatemic osteomalacia: case report and review of the literature

Arquivos brasileiros de endocrinologia e metabologia
Rodrigo O MoreiraMaria Lucia F Farias

Abstract

Adult-onset hypophosphatemic osteomalacia is a rare disease characterized by hypophosphatemia, increased levels of alkaline phosphatase and decreased bone mass. Oral supplementation with phosphate and vitamin D is the main treatment and, in cases of oncogenic osteomalacia, tumor resection is mandatory. We report the case of a patient with hypophosphatemic osteomalacia of an unknown cause. Despite extensive search, no tumor was found. The patient was treated with phosphate for a long period and developed tertiary hyperparathyroidism. Serum PTH levels did not return to normal after surgical excision of three parathyroids and the patient refused to continue clinical investigation and treatment. After ten years absent from the hospital, during which medications were used irregularly, she was admitted with multiple fractures and respiratory insufficiency caused by severe thoracic deformities, and died. The authors discuss the relationship between osteomalacia and hyperparathyroidism and the aggressive course of the disease.

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Citations

Feb 7, 2009·Arquivos brasileiros de endocrinologia e metabologia·Gleyne Lopes Kujew BiaginiRicardo Ribeiro Gama

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