Diabètes phosphatés

Abstract

Phosphated diabetes are rare diseases, characterized by renal phosphate wasting, which results in hypophosphatemia, bone demineralization and osteomalacia. We review the pathophysiology of phosphate metabolism, revolutionized by the discovery of phosphatonines, particularly the FGF23, which sheds a new light on the various etiologies which are detailed: tumor-induced osteomalacia, genetic phosphate diabetes (X-linked hypophosphatemia, autosomal-dominant hypophosphatemic rickets, autosomal-recessive hypophosphatemic rickets, hypophosphatemic rickets with hypercalciuria, hypophosphatemia with nephrolithiasis by mutation of NPT2A and NHERF1), hyperparathyroidism, Fanconi syndrome and drug-induced phosphated diabetes. Diagnostic tools, improved by FGF23 dosage and treatment are also discussed.