Chronic hypophosphatemia caused by decreased intestinal absorption or increased renal clearance, may lead to rickets or osteomalacia independently of other predisposing abnormalities. The conditions commonly associated with increased renal
clearance of
phosphate are X-linked hypophosphatemic rickets, tumor associated rickets/osteomalacia, RTA and Fanconi syndrome.
Recently we experienced 3 men with adult-onset, histologically proven osteomalacia associated with increased renal clearance of phosphate. None of them had a family history of bone disease, tumors or other tubular defects. All of these had
remarkable
biochemical and clinical improvement with medical treatment such as 1,25-dihydroxyvitamin D and phosphate supplementation. Although we did not find tumors yet, we could not the possibility of tumor-associated osteomalacia since it often takes
several
years to make a diagnosis because of small size, benign nature and unusual location of tumors. Thus, carefullong-term follow up for tumor occurrence will be maintained in these patients with sporadic nonfamilial hypophosphatemic osteomalacla (J
Kor
Soc
Endocrinol 9: 25~31, 1994)
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