Ann Orthop Musculoskelet Disord | Volume 1, Issue 2 | Research Article | Open Access
Helen E Gruber1*, Robert K Rude2, Charles F Sharp3, Elisabeth Ryzen4 and Frederick R Singer5
1Department of Orthopaedic Surgery, Carolinas Medical Center, USA
2Department of Medicine, University of Southern California School of Medicine and Orthopaedic Hospital, USA
3Department of Endocrinology, Keck Medical Center of the University of Southern California, USA
4Department of Endocrinology and Metabolism, Stanford University, USA
5Department of Endocrinology, John Wayne Cancer Institute at Providence Saint John's Hospital and Health Center, USA
*Correspondance to: Helen E Gruber
Fulltext PDFObjective: Little information is available in the literature regarding bone histologic features in patients with the interesting but rare condition of acquired hypophosphatemic osteomalacia. Our objectives here were to document bone features and provide bone histomorphometric and clinical and serum biochemistry findings on two patients with this disorder. Subjects: A 36-year-old female and a 53-year-old male.
Methods: Studies were performed following institutional review board review. Histories and radiologic examinations showed multiple fractures. Biochemical evaluation showed serum phosphorus values of 2.0 mg/dl and serum alkaline phosphatase values of 263 and 313 IU/l. Iliac crest bone biopsies following tetracycline labeling were performed; quantitative histomorphometry showed elevated osteoid thickness (114 and 91 µm) and % osteoid volumes (41% and 54%). Indices of bone resorption were normal. Conclusions: Here we present quantitative bone histomorphometric data and other skeletal and biochemical features, from two adults with acquired hypophosphatemic osteomalacia which expand the information available on patients with this rare and challenging condition of hypophosphatemic osteomalacia. The first patient reported here expired due to a tumor which was diagnosed late in the patient’s course, but no tumor was identified in the second patient after 7.6 years of follow-up.
Hypophosphatemic osteomalacia; Bone histomorphometry; Tumor-induced osteomalacia
Gruber HE, Rude RK, Sharp CF, Ryzen E, Singer FR. Adult Acquired Hypophosphatemic Osteomalacia: Bone Biopsy and Skeletal Features in Two Patients. Ann Orthop Musculoskelet Disord. 2018;1(2):1009.