Clinical diagnosis and treatment of 17 cases of hypophosphatemic osteomalacia in adults

Abstract

Objective To investigate the etiology, diagnosis, treatment and prognosis of hypophosphatemic osteomalacia in adults, and to provide diagnostic approach to reduce the rate of misdiagnosis and missed diagnosis. Methods The clinical data of 17 adult inpatients with hypophosphatemic osteomalacia in the First Affiliated Hospital of Zhengzhou University from March 2013 to November 2018 were retrospectively analyzed, and their clinical characteristics, biochemical examination, imaging manifestations, clinical treatment and efficacy were summarized. Result All the patients presented with different degrees of bone pain, muscle weakness and activity limitation. Biochemical examination showed hypophosphatemia, and imaging showed the fracture of different parts in these patients. Tumor-induced osteomalacia in all patients were surgically removed, while hereditary or sporadic patients were given neutral phosphorus solution (formulated with disodium hydrogen phosphate, potassium dihydrogen phosphate and distilled water) orally.Meanwhile, both groups were given calcitriol capsule (roquetry) and calcium carbonate D3 (caltic). During follow-up, the symptoms of bone pain and muscle weakness were alleviated, the activity function was improved, and the quality of life was improved. Conclusions Hypophosphatemic osteomalacia in adults is rare, most have multiple bone pains, fractures and muscle weakness due to unknown causes.The etiological diagnosis is very important, and it is easy to be missed or misdiagnosed. According to the biochemical indicators of patients and the characteristics of imaging examinations, the vigilance of the disease should be improved and the understanding of its diagnosis and treatment should be strengthened. Key words: Hypophosphatemic osteomalacia; Bone pain; Tumor-induced osteomalacia; Fibroblast growth factor