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Hypophosphatemia

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https://www.readbyqxmd.com/read/29446010/phosphaturic-mesenchymal-tumors-what-an-endocrinologist-should-know
#1
REVIEW
J M Boland, P J Tebben, A L Folpe
Tumor-induced osteomalacia (TIO), also known as "oncogenic osteomalacia", is a rare cause of osteomalacia. TIO often has an insidious onset characterized clinically by progressive muscle weakness and bone pain with fractures. The hallmark biochemical finding is a persistent low serum phosphorus concentration due to renal phosphate wasting. The vast majority of cases of TIO result from production of the phosphaturic hormone fibroblast growth factor 23 (FGF23) by a histologically distinctive mesenchymal tumor, termed "phosphaturic mesenchymal tumor" (PMT)...
February 14, 2018: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/29445220/association-of-admission-serum-levels-of-vitamin-d-calcium-phosphate-magnesium-and-parathormone-with-clinical-outcomes-in-neurosurgical-icu-patients
#2
Seyed Hossein Ardehali, Salman Dehghan, Ahmad Reza Baghestani, Aynaz Velayati, Zahra Vahdat Shariatpanahi
To evaluate the association of admission serum levels of 25(OH)D, parathormone and the related electrolytes with severity of illness and clinical outcomes in neurosurgical critically ill patients, serum levels of 25(OH)D, parathormone, calcium, magnesium, and phosphate, along with APACHE II score were measured for 210 patients upon admission. Mean serum 25(OH)D was 21.1 ± 7.4 ng/mL. 25(OH)D deficiency (less than 20 ng/dL) and elevated serum parathormone level were found in 47.6% and 38% of patients respectively...
February 14, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29444509/associations-between-intravenous-iron-inflammation-and-fgf23-in-non-dialysis-patients-with-chronic-kidney-disease-stages-3-5
#3
Katarzyna Muras-Szwedziak, Michal Nowicki
BACKGROUND/AIMS: Both iron deficiency and chronic inflammation are highly prevalent in patients with chronic kidney disease (CKD). The effect of intravenous iron infusion on mineral metabolism in CKD may be modified by inflammation. Intravenous iron theraphy may reduce peripheral degradation, secretion, clearence of iFGF23 and lead to hypophosphatemia. The aim of the study was to evaluate the effect of intravenous iron on mineral metabolism in CKD patients. METHODS: 35 non-dialysis patients with CKD stages 3-5...
February 8, 2018: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29442350/occult-phosphaturic-mesenchymal-tumor-of-femur-cortex-causing-oncogenic-osteomalacia-diagnostic-challenges-and-clinical-outcomes
#4
Deep Dutta, Raghuvansh Kumar Pandey, Rakhee Gogoi, Nagender Solanki, Renu Madan, Anupam Mondal, Shruti Dogra, Pradeep Thapa
BACKGROUND: Tumor induced osteomalacia (TIO) are extremely rare paraneoplastic syndrome with less than 300 reported cases. This report highlights the pitfalls and challenges in diagnosing and localizing TIO in patients with refractory and resistant osteomalacia. PATIENT AND METHODS: 41- year gentleman with 4-year history of musculoskeletal weakness and pathologic fractures presented in wheelchair bound incapacitated state of 1-year duration. Investigations were significant for severe hypophosphatemia, severe phosphaturia, normal serum calcium, reduced 1,25-dihydroxy vitamin-D, elevated ALP, elevated intact parathyroid hormone (iPTH), and pseudo-fractures involving pelvis and bilateral femur...
February 14, 2018: Endokrynologia Polska
https://www.readbyqxmd.com/read/29435763/functions-of-vitamin-d-in-bone
#5
REVIEW
D Goltzman
Vitamin D, synthesized in the skin or absorbed from the diet, undergoes multi-step enzymatic conversion to its active form, 1,25-dihydroxy vitamin D [1,25(OH) 2 D], followed by interaction with the vitamin D receptor (VDR), to modulate target gene expression. Loss-of function mutations in the genes encoding the enzymes regulating these processes, or in the VDR, result in human diseases, which have demonstrated the paramount role of 1,25(OH) 2 D in mineral and skeletal homeostasis. Mouse genetics has been used to create disease phenocopies which have produced considerable insight into the mechanisms of 1,25(OH) 2 D regulation of mineral and skeletal metabolism...
February 12, 2018: Histochemistry and Cell Biology
https://www.readbyqxmd.com/read/29417983/rare-genetically-conditioned-forms-of-rickets-differential-diagnosis-and-advances-in-diagnostics-and-treatment
#6
REVIEW
I Michałus, A Rusińska
Apart from the classic forms of rickets, there are rare genetic disorders from the group of vitamin D-resistant rickets where the clinical picture is very similar to the classic forms. Diagnosis of genetically conditioned rickets is often delayed. It is very important to know that a disorder of genetic background may be the cause of the failure of classic treatment in patients with rachitic symptoms. In the group of genetically conditioned rickets there are, among others, congenital hypophosphatemic rickets and vitamin D-dependent rickets type I and II...
February 8, 2018: Clinical Genetics
https://www.readbyqxmd.com/read/29417614/comparative-safety-of-intravenous-ferumoxytol-vs-ferric-carboxymaltose-in-iron-deficiency-anemia-a-randomized-trial
#7
N Franklin Adkinson, William E Strauss, Iain C Macdougall, Kristine E Bernard, Michael Auerbach, Robert F Kaper, Glenn M Chertow, Julie S Krop
Few trials have examined rates of hypersensitivity reactions (HSRs) with intravenous iron formulations used to treat iron deficiency anemia. This randomized, multicenter, double-blind clinical trial compared the safety and efficacy of ferumoxytol versus ferric carboxymaltose (FCM), focusing on rates of HSRs and hypotension as the primary end point. Patients with iron deficiency anemia of any etiology in whom oral iron was unsatisfactory or intolerable received ferumoxytol (n = 997) or FCM (n = 1000) intravenously over ≥15 minutes on days 1 and 8 or 9 for total respective doses of 1...
February 8, 2018: American Journal of Hematology
https://www.readbyqxmd.com/read/29417593/medical-findings-in-1-026-consecutive-adult-inpatient-residential-eating-disordered-patients
#8
Philip S Mehler, Dan V Blalock, Keegan Walden, Simrat Kaur, Jennifer McBride, Kristine Walsh, Jennifer Watts
OBJECTIVE: Eating disorders are associated with multiple medical complications. We report contemporary medical data, for newly admitted adult inpatient and residential level of care patients. METHOD: Medical records of a transdiagnostic sample of 1,026 patients, with eating disorders, were retrospectively reviewed for the presence of a broad array of medical complications at time of admission. The prevalence of physiologically relevant medical complications was assessed across major eating disorder categories...
February 8, 2018: International Journal of Eating Disorders
https://www.readbyqxmd.com/read/29405468/prevention-of-hypophosphatemia-during-continuous-renal-replacement-therapy-an-overlooked-problem
#9
EDITORIAL
Michael Heung, Bruce A Mueller
Hypophosphatemia is a common and potentially serious complication occurring during continuous renal replacement therapy (CRRT). Phosphate supplementation is required in the vast majority of patients undergoing CRRT, particularly beyond the first 48 hours. Supplementation can be provided either as a standalone oral or parenteral treatment or as an additive to CRRT solutions. Each approach has advantages and disadvantages, and clinicians must weigh the individual factors most relevant in their practice setting...
February 5, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29401002/phosphatidylinositol-3-kinase-%C3%AE-selective-inhibition-with-alpelisib-byl719-in-pik3ca-altered-solid-tumors-results-from-the-first-in-human-study
#10
Dejan Juric, Jordi Rodon, Josep Tabernero, Filip Janku, Howard A Burris, Jan H M Schellens, Mark R Middleton, Jordan Berlin, Martin Schuler, Marta Gil-Martin, Hope S Rugo, Ruth Seggewiss-Bernhardt, Alan Huang, Douglas Bootle, David Demanse, Lars Blumenstein, Christina Coughlin, Cornelia Quadt, José Baselga
Purpose We report the first-in-human phase Ia study to our knowledge ( ClinicalTrials.gov identifier: NCT01219699) identifying the maximum tolerated dose and assessing safety and preliminary efficacy of single-agent alpelisib (BYL719), an oral phosphatidylinositol 3-kinase α (PI3Kα)-selective inhibitor. Patients and Methods In the dose-escalation phase, patients with PIK3CA-altered advanced solid tumors received once-daily or twice-daily oral alpelisib on a continuous schedule. In the dose-expansion phase, patients with PIK3CA-altered solid tumors and PIK3CA-wild-type, estrogen receptor-positive/human epidermal growth factor receptor 2-negative breast cancer received alpelisib 400 mg once daily...
February 5, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29396136/renal-replacement-therapy-in-the-neonatal-intensive-care-unit
#11
Tze Yee Diane Mok, Min-Hua Tseng, Ming-Chou Chiang, Ju-Li Lin, Shih Ming Chu, Jen-Fu Hsu, Reyin Lien
BACKGROUND: Renal replacement therapy (RRT) is becoming increasingly necessary for supporting critically ill neonates. Few studies have reported the use of RRT in the neonatal intensive care unit (NICU). Therefore, we performed a retrospective study to describe the use of RRT in our NICU and its associated efficacy, complications, and outcomes. METHODS: We identified patients requiring RRT between January 2009 and January 2017. Demographic data, mode of RRT, and associated factors were recorded...
December 21, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29390586/a-case-report-of-phosphaturic-mesenchymal-tumor-induced-osteomalacia
#12
Weiqian Wu, Chongyang Wang, Jianwei Ruan, Feng Chen, Ningjun Li, Fanghu Chen
RATIONALE: Tumor-induced osteomalacia (TIO) is a rare and often misdiagnosed syndrome. Surgical resection is currently the first line treatment for TIO. PATIENT CONCERNS: Here we report the case of a 49-year-old woman presented with intermittent pain in the right chest and bilateral hip that had persisted for over two years. DIAGNOSES: She was diagnosed of TIO caused by a phosphaturic mesenchymal tumor based on the following examinations. Laboratory tests revealed high serum alkaline phosphatase, high urinary phosphorus, hypophosphatemia and normal serum calcium levels...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29383408/three-month-randomized-clinical-trial-of-nasal-calcitonin-in-adults-with-x-linked-hypophosphatemia
#13
Rebecca Sullivan, Alice Abraham, Christine Simpson, Elizabeth Olear, Thomas Carpenter, Yanhong Deng, Chuqing Chen, Karl L Insogna
Previous work has demonstrated that a single subcutaneous dose of salmon calcitonin leads to a transient decline in circulating levels of FGF23 in patients with X-linked hypophosphatemia (XLH). Since the calcitonin receptor is expressed on osteocytes, this raises the possibility that interdicting signals through that receptor could modulate circulating levels of FGF23 in XLH. In the present study, 21 subjects with XLH were randomly assigned to receive either placebo nasal spray or 400 IU of nasal salmon calcitonin daily for three months...
January 30, 2018: Calcified Tissue International
https://www.readbyqxmd.com/read/29381780/x-linked-hypophosphatemia-and-fgf23-related-hypophosphatemic-diseases-prospect-for-new-treatment
#14
Yuka Kinoshita, Seiji Fukumoto
Phosphate plays essential roles in many biological processes, and the serum phosphate level is tightly controlled. Chronic hypophosphatemia causes impaired mineralization of the bone matrix and results in rickets and osteomalacia. Fibroblast growth factor 23 (FGF23) is a bone-derived hormone that regulates phosphate metabolism. FGF23 excess induces hypophosphatemia via impaired phosphate reabsorption in the renal proximal tubules and decreased phosphate absorption in the intestines. There are several types of genetic and acquired form of FGF23-related hypophosphatemic diseases...
January 26, 2018: Endocrine Reviews
https://www.readbyqxmd.com/read/29380000/tumor-induced-osteomalacia-in-association-with-pten-negative-cowden-syndrome
#15
J A Berglund, R I Gafni, F Wodajo, E W Cowen, D El-Maouche, R Chang, C C Chen, L C Guthrie, A A Molinolo, M T Collins
Tumor-induced osteomalacia (TIO) is a rare paraneoplastic condition in which phosphaturic mesenchymal tumors (PMTs) secrete high levels of fibroblast growth factor 23 (FGF23) into the circulation. This results in renal phosphate wasting, hypophosphatemia, muscle weakness, bone pain, and pathological fractures. Recent studies suggest that fibronectin-fibroblast growth factor receptor 1 (FN1-FGFR1) translocations may be a driver of tumorigenesis. We present a patient with TIO who also exhibited clinical findings suggestive of Cowden syndrome (CS), a rare autosomal dominant disorder characterized by numerous benign hamartomas, as well as an increased risk for multiple malignancies, such as thyroid cancer...
January 29, 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29354168/glomus-tumor-as-a-cause-of-oncogenic-osteomalacia
#16
Mehdi Dehghani, Mohammad Hossien Dabbaghmanesh, Abolfazele Khalafi-Nezhad, Nader Riazmontazer, Amireza Dehghanian, Reza Vojdani, Mohammadreza Sasani
Many tumors that occasionally are benign in origin causes hypophosphatemic osteomalacia. Here we present a case of glomus tumor in a 59-year-old man with oncogenic osteomalacia. Diagnosis was made after observation of abnormal increase activity in octreotide scan. The magnetic resonance imaging showed a round lesion in left ankle joint. Surgical excision of tumor was curative and all symptoms and intractable hypophosphatemia improved after few weeks.
September 2017: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/29319766/epic-trial-education-programme-impact-on-serum-phosphorous-control-in-ckd-5d-patients-on-hemodialysis
#17
Carmen Tzanno Branco Martins, Bárbara Margareth Menardi Biavo, Clarissa Baia Bargas Uezima, Jacqueline Alves Pereira Dos Santos, Camila Machado de Barros, Elzo Ribeiro Júnior, Paul Clesca Troconis, Cristoforo Scavone, Marcus Vinicius de Souza João Luiz
INTRODUCTION: In stage 5D chronic kidney disease (CKD 5D) patients, the encouragement of treatment adherence by health professionals is a significant clinical challenge. OBJECTIVES: This study evaluates the impact of a nutritional education programme on hyperphosphatemia, utilizing the transtheoretical model of behavior change (TMBC). SUBJECTS AND METHODS: A prospective interventional study comprising 179 CKD 5D patients with hypophosphatemia...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29315336/hyperphosphatemia-is-associated-with-high-mortality-in-severe-burns
#18
George Kuo, Cheng-Chia Lee, Shih-Yi Yang, Yen-Chang Hsiao, Shiow-Shuh Chuang, Su-Wei Chang, Kun-Hua Tu, Pei-Chun Fan, Ya-Chung Tian, Yung-Chang Chen, Chih-Hsiang Chang
INTRODUCTION: Phosphate level is often deranged during acute illness, regardless of the presence of kidney injury or not. A few studies described that hypophosphatemia may associated with outcome in patients admitted to the burn unit, but the literatures for hyperphosphatemia is limited. Our study aims to evaluate if hyperphosphatemia, one of the sign of severe tissue damage or kidney injury, will associate with mortality of patients with severe burns. MATERIALS AND METHODS: The study was a post hoc analysis of prospectively collected data from patients admitted to the burn unit between September 2006 and December 2011...
2018: PloS One
https://www.readbyqxmd.com/read/29310342/efficacy-and-safety-of-regorafenib-for-advanced-gastrointestinal-stromal-tumor-after-failure-with-imatinib-and-sunitinib-treatment-a-meta-analysis
#19
Zhenan Zhang, Tao Jiang, Wensheng Wang, Daxun Piao
AIMS: This meta-analysis aimed to evaluate the safety and efficacy of regorafenib as a treatment for patients with advanced (metastatic and/or unresectable) gastrointestinal stromal tumor (AGIST) after developing resistance to imatinib and sunitinib. METHODS: A literature search of databases such as PubMed, Embase, and Cochrane library was conducted up to February 2017. The pooled percentages and the corresponding 95% confidence intervals (CIs) were calculated using the Stata 11...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29308755/-hypophosphatemia-is-associated-with-poor-prognosis-of-critically-ill-patients-a-meta-analysis-of-1-555-patients
#20
Bo Liu, Yumei Cheng, Feng Shen, Yahui Wang, Yanqi Wu, Ling Yao, Yuqing Liu, Xianbi Gou
OBJECTIVE: To evaluate the relationship between hypophosphatemia and prognosis in critically ill patients. METHODS: Some hypophosphatemia-associated prospective or retrospective clinical cohort studies were searched through CNKI, Wanfang Data, PubMed, Embase, Cochrane library, and Google Scholar English database respectively, with the guidance of these key words such as hypophosphatemia, intensive care, prognosis and fatality rate. The articles were concerned about the correlation between hypophosphatemia and the prognosis of patients in intensive care unit (ICU)...
January 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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