Bone densitometry in a patient with hypophosphatemic osteomalacia

Authors: Negri, Armando L.¹; Bogado, Cesar E.²; Zanchetta, Jose R.²

Source: Journal of Bone and Mineral Metabolism, Volume 22, Number 5, September 2004 , pp. 514-517(4)

Publisher: Springer

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Abstract:

A 60-year-old Caucasian woman with a 1-year history of pain at the ribs, spine, and pelvis consulted at our Institute in March 1999. She brought a bone densitometry performed using a Lunar DPX densitometer that showed bone mineral density (BMD) measurements in the osteoporotic range at both the lumbar spine and the femoral neck. As a child she had had bowed legs and had been treated with ultraviolet radiation. Results of the laboratory test performed at our institute showed normal total serum calcium, repeated low serum P levels, and a low renal phosphate threshold with elevated total and bone fraction of alkaline phosphatase with normal intact parathyroid hormone (PTH). A diagnosis of hypophosphatemic osteomalacia due to renal phosphate leak was made. She began treatment with neutral sodium phosphate at 1.5 g/day and calcitriol 0.5 µg/day. Her serum P levels normalized, and there was a progressive decrease in alkaline phosphatase levels. The densitometry showed a very rapid increase in BMD values with normalization at the lumbar spine after 10 months of treatment. This case shows the importance of bone densitometry in the follow-up of patients with suspected osteomalacia.

Keywords: osteomalacia; densitometry; renal phosphate leak; hypophosphatemia

Document Type: Research article

DOI: http://dx.doi.org/10.1007/s00774-004-0516-0

Affiliations: 1: Instituto de Investigaciones Metabólicas, Libertad 836, 1 piso, Buenos Aires, 1012, Argentina, Email: negri@casasco.com.ar 2: Instituto de Investigaciones Metabólicas, Libertad 836, 1 piso, Buenos Aires, 1012, Argentina,

Publication date: 2004-09-01