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Plasma vitamin D metabolites in a patient with sporadic hypophosphataemic osteomalacia (adult‐onset type)
Author(s) -
ULMANN ANDRE,
BOUCHARD PHILIPPE,
GARABEDIAN MICHELE,
BOURDEAU AGNES,
WITMERCOURNOT GIULIA,
LACOUR BERNARD,
BALSAN SONIA,
FUNCKBRENTANO JEANLOUIS
Publication year - 1980
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/j.1365-2362.1980.tb00047.x
Subject(s) - osteomalacia , medicine , endocrinology , parathyroid hormone , vitamin d and neurology , phosphorus , vitamin , chemistry , basal (medicine) , ergocalciferol , cholecalciferol , calcium , organic chemistry , insulin
. Sporadic hypophosphataemic osteomalacia (adult‐onset type) was demonstrated in a 40‐year‐old man on the basis of severe osteomalacia, hypophos‐phataemia, hyperphosphaturia and glycinuria. Plasma immunoreactive parathyroid hormone (iPTH) concentration was 9‐3 ng prot./ml (normal range: 4–8 ng prot./ml). Plasma 25‐hydroxy‐vitamin D and 24, 25‐dihydroxy‐vitamin D concentrations were 11 and 2–4 ng/ml respectively. Basal lα, 25‐dihydroxy‐vitamin D concentrations were slightly elevated (116 and 96 pg/ml) and increased to 240 pg/ml after 3 days on a low‐phosphorus diet. The patient was put on oral treatment with 25‐hydroxycholecalciferol (100 μ per day) and phosphorus (1500 mg per day). On the 4th month on treatment, a clinical improvement was apparent. Plasma 25(OH) D was 44 ng/ml, plasma l,25 (OH) 2 D was 256 pg/ml. However, plasma phosphorus remained low (0.77 mmol/l). On the 9th month of treatment a radiological improvement was evident despite a persistent hypophosphataemia (0.68 mmol/I). These facts suggest in our patient the existence of a vitamin D‐independent renal phosphorus leak.