Abstract
In this case, a young male patient diagnosed as hypophosphatemic osteomalacia and ankylosing spondylitis (AS) will be assessed by literature. A 32-year-old male patient who had been previously diagnosed as ankylosing spondylitis and hypophosphatemic osteomalacia was admitted to our clinic. In the beginning of the disease, he complained of pain on the first metatarsal bone and low back. Sacroiliac magnetic resonance (MR) images were interpreted as sacroiliitis. He was diagnosed as AS, and referred to many hospitals and received several therapies. He did not benefit from the treatment and his complaints worsened. The human leukocyte antigen (HLA) B-27 test was negative and alkaline phosphatase level was high. Old femur fractures were reported in the whole body bone scintigraphy. In addition, the patient was diagnosed with osteomalacia. While the patient was receiving vitamin D, oral phosphate, anti-tumor necrosis factor therapy was added. Patient’s diagnosis was reevaluated. His final diagnosis was hypophosphatemic osteomalacia instead of ankylosing spondylitis.
References
Sivas F, Günesen Ö, Özoran K, Alemdaroğlu E (2007) Osteomalacia from Mg-containing antacid: a case report of bilateral hip fracture. Rheumatol Int 27:679–681
Reyskens M, Sleurs K, Verresen L, Janssen M, van den Berg J, Geusens P (2015) Hypophosphatemic osteomalacia: an unusual clinical presentation of multiple myeloma. Osteoporos Int 26(7):2039–2042
Bhadada SK, Bhansali A, Upreti V, Dutta P, Santosh R, Das S, Nahar U (2010) Hypophosphataemic rickets/osteomalacia: a descriptive analysis. Indian J Med Res 131:399–404
Gifre L, Peris P, Monegal A, Martinez de Osaba MJ, Alvarez L, Guañabens N (2011) Osteomalacia revisited: a report on 28 cases. Clin Rheumatol 30:639–645
Burnstein MI, Lawson JP, Kottamasu SR, Ellis BI, Micho J (1989) The enthesopathic changes of hypophosphatemic osteomalacia in adults: radiologic findings. AJR 153:785–790
Gupta AD (2009) Sacroiliac joint pathologies in low back pain. J Back Musculoskelet Rehabil 22:91–97
Garip Y, Dedeoglu M, Bodur H (2014) Osteomalacia mimicking spondyloarthropathy: a case report. Osteoporos Int 25(7):1983–1985
Hoshino C, Satoh N, Sugawara S, Kuriyama C, Kikuchi A, Ohta M (2008) Sporadic adult-onset hypophosphatemic osteomalacia caused by excessive action of fibroblast growth factor 23. Inter Med 47:453–457
Demirbilek H, Aydoğdu D, Özön A (2010) Vitamin D-deficient rickets mimicking ankylosing spondylitis in an adolescent girl. Turk J Pediatr 54:177–179
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Informed consent was obtained from the patient.
Conflicts of interest
None.
Rights and permissions
About this article
Cite this article
Sivas, F., Yurdakul, F.G., Durak, M. et al. Hypophosphatemic osteomalacia: a case simulating anklylosing spondylitis treated with anti-TNF therapy. Osteoporos Int 27, 3651–3654 (2016). https://doi.org/10.1007/s00198-016-3758-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00198-016-3758-5