成人型ビタミンＤ抵抗性骨軟化症の一症例

Abstract

A case of vitamin D resistant osteomalacia was reported.A 22-year-old man, who complained of back pain, gait disturbance and polyarthralgia, was admitted to our hospital on 7 Jan, 1986. The patient was diagnosed as vitamin D resistant osteomalacia based on clinical and laboratory findings. By treatment with 1-α-OH-D3 [Alfarol] and NaH2Po42H2O (Sodium Dihydrogenphosphate Dihydrate), the subjective and clinical findings were improved. Two interesting findings were seen in this case. The one is the radiological finding of the sacro-iliacal joint. In the a-p view of the pelvis the sacro-iliacal joint was not seen as if the joint was fused and the part of the pelvis consisted of one bone.The joint was not seen also in the oblique view of the joint. But CT examination revealed that the joint was present. Change of the plane of the joint due to deformity of the posterior part of the pelvis and osteomalacia were the causes of failure to describe the joint notwithstanding the oblique view was examined. The other is the histological findings of the iliac bone. In spite of distinct improvement of clinical and laboratory findings by the treatment, histological findings after 5 months were same as that before the treatment.