Vitamin D Metabolite Levels in Oncogenic Osteomalacia

Ra, Sweet; Males, James L.; Hamstra, Alan J.; DeLuca, Hector F.

doi:10.7326/0003-4819-93-2-279

Cited by 78 publications

(12 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In 1977, Drezner & Feinglos recognized impaired 1a-hydroxylation as a characteristic biochemical abnormality of the syndrome, which was later confirmed by Sweet et al (17,18). In 2001, Shimada et al identified FGF-23 as the causative humoral factor of TIO (19).…”

Section: Discussionmentioning

confidence: 96%

Tumor producing fibroblast growth factor 23 localized by two-staged venous sampling

Boekel¹,

Ruinemans-Koerts²,

Joosten³

et al. 2008

European Journal of Endocrinology

View full text Add to dashboard Cite

Background: Tumor-induced osteomalacia is a rare paraneoplastic syndrome characterized by hypophosphatemia, renal phosphate wasting, suppressed 1,25-dihydroxyvitamin D production, and osteomalacia. It is caused by a usually benign mesenchymal tumor producing fibroblast growth factor 23 (FGF-23). Surgical excision of the tumor is the first choice of treatment because complete resection is curative. Unfortunately, localization often fails due to the small size of these neoplasms. According to the current standards, supportive care with oral phosphate and calcitriol is the only feasible option in such cases. Case: In this report, we describe the diagnostic value of two-staged venous sampling to localize the FGF-23 secreting tumor in a case where conventional imaging failed. In addition, we examined the effect of dipyridamole on renal phosphate excretion, explored the efficacy of octreotide and calcitonin to suppress the FGF-23 production, and closely evaluated the hormonal changes following successful removal of the tumor. The latter observations indicate that calcitonin may be useful to suppress tumor-FGF-23 production and that FGF-23 may be a clinically relevant inhibitor of parathyroid hormone secretion in man.

show abstract

Section: Discussionmentioning

confidence: 96%

Tumor producing fibroblast growth factor 23 localized by two-staged venous sampling

Boekel¹,

Ruinemans-Koerts²,

Joosten³

et al. 2008

European Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…This syndrome is thought to be caused by humoral factors produced by one of several tumor types that inhibit renal tubular reabsorption of phosphate, other proximal renal tubular functions, and 1␣-hydroxylation of 25-hydroxyvitamin D 3 . Resolution of the syndrome after tumor removal (7)(8)(9)(10)(11)(12)(13)(14) and reproduction of the syndrome by tumor xenografting in athymic mice (15)(16)(17) and bioassays of tumor cell-conditioned culture media (18 -22) or tumor extracts (16) provide support for this hypothesis.…”

Section: T Umor-induced Osteomalacia (Tumor-induced Hy-mentioning

confidence: 56%

“…A complete resection is curative and will result in reversal of all biochemical abnormalities (7)(8)(9)(10)(11)(12)(13)(14). When complete resection of the causative tumor is not successful or not possible, correction of the two major biochemical abnormalities, i.e.…”

Section: T Umor-induced Osteomalacia (Tumor-induced Hy-mentioning

confidence: 99%

Use of Long-Term Intravenous Phosphate Infusion in the Palliative Treatment of Tumor-Induced Osteomalacia

Yeung¹,

McCutcheon

Schultz³

et al. 2000

The Journal of Clinical Endocrinology & Metabolism

View full text Add to dashboard Cite

Tumor-induced osteomalacia is characterized by paraneoplastic defects in vitamin D metabolism, proximal renal tubular functions, and phosphate transport. The resulting hypophosphatemia can cause generalized pain and muscle weakness, which significantly affect the quality of life of the patients. Palliative treatment with calcium, vitamin D, and phosphate replacement is indicated for patients in whom the causative tumor cannot be completely resected. In this report we describe a case of tumor-induced osteomalacia in whom adequate oral doses of phosphate could not be used because of gastrointestinal side-effects. Long term (3-6 months) iv phosphate infusion delivered by ambulatory infusion pumps in combination with oral calcium and vitamin D was used successfully to decrease pain and increase muscle strength. Careful monitoring of serum calcium, phosphate, and creatinine levels and reliable microinfusion technology have allowed the long term use of iv phosphate infusion without serious morbidity. This patient received repeated (three times) phosphate infusions over 8 yr, resulting in laboratory and symptomatic improvement after each course. However, this patient did suffer two episodes of central venous catheter-related infection. Because of potentially serious complications, such as severe hypocalcemia, calcified right ventricular thrombi, and nephrocalcinosis, long term iv phosphate infusion should be reserved for patients who cannot tolerate adequate doses of oral phosphate and for whom the benefits outweigh the risks. (J Clin Endocrinol Metab 85: 549 -555, 2000)

show abstract

“…It is not clear whether the increased production of 1,25(OH) 2 D after correction of acidosis was an essential factor in bone healing, but the known effect of the hormone in increasing intestinal calcium and phosphate absorption might well have contributed to this effect. A similar surge in the serum level of 1,25-(OH) 2 D accompanying the healing of bone disease has been reported in oncogenic osteomalacia after surgical removal of the responsible tumour [29], where the factor inhibiting 25(OH)D hydroxylation is thought to be the humoral presence of a phosphatonin secreted by the tumour [30]. …”

Section: Discussionmentioning

confidence: 92%

Distal Renal Tubular Acidosis: Alkali Heals Osteomalacia and Increases Net Production of 1,25-Dihydroxyvitamin D

Wrong

Henderson²,

Kaye³

2005

Nephron Physiol

View full text Add to dashboard Cite

show abstract

Vitamin D Metabolite Levels in Oncogenic Osteomalacia

Cited by 78 publications

References 7 publications

Tumor producing fibroblast growth factor 23 localized by two-staged venous sampling

Tumor producing fibroblast growth factor 23 localized by two-staged venous sampling

Use of Long-Term Intravenous Phosphate Infusion in the Palliative Treatment of Tumor-Induced Osteomalacia

Distal Renal Tubular Acidosis: Alkali Heals Osteomalacia and Increases Net Production of 1,25-Dihydroxyvitamin D

Contact Info

Product

Resources

About