Journal of Orthopaedic Science

, Volume 6, Issue 2, pp 193–198

The association of neurofibromatosis 1 and spinal deformity with primary hyperparathyroidism and osteomalacia: might melatonin have a role?

  • Mohamed E. Abdel-Wanis
  • Norio Kawahara
  • Katsuro Tomita

DOI: 10.1007/s007760100071

Cite this article as:
Abdel-Wanis, M., Kawahara, N. & Tomita, K. J Orthop Sci (2001) 6: 193. doi:10.1007/s007760100071

Abstract

A 35-year-old woman with neurofibromatosis 1 and thoracic kyphoscoliosis had incomplete paraplegia. She had a history of hyperparathyroidism due to a parathyroid adenoma which had been excised 4 years previously. Plain radiographs of the spine revealed kyphoscoliosis from the third to sixth thoracic vertebrae. Kyphosis and scoliosis angles were 86° and 28°, respectively. Radiographs of the skull and hands showed radiological changes suggestive of hyperparathyroidism. Laboratory tests showed low-normal serum calcium, hypophosphatemia, elevated serum alkaline phosphatase, and low serum 25-hydroxyvitamin D. Retrospective review of the patient's laboratory data showed that she had osteomalacia at the time of diagnosis of primary hyperparathyroidism. The patient had been treated by anterior and posterior decompression and fusion with posterior instrumentation through a single posterior approach. The postoperative kyphosis and scoliosis angles were 30° and 12°, respectively. Neurological recovery and spinal fusion had been achieved. Osteomalacia responded well to vitamin D therapy. This is the first case of coexisting neurofibromatosis 1, primary hyperparathyroidism due to parathyroid adenoma and osteomalacia to be reported in the literature. The osteomalacia in this patient could be related to primary hyperparathyroidism, and not to neurofibromatosis 1. A drop in melatonin level after parathyroidectomy may have been the cause of spinal curvature progression in this patient.

Key words Neurofibromatosis Scoliosis Hyperparathyroidism Osteomalacia Melatonin 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Copyright information

© The Japanese Orthopaedic Association 2001

Authors and Affiliations

  • Mohamed E. Abdel-Wanis
    • 1
  • Norio Kawahara
    • 1
  • Katsuro Tomita
    • 1
  1. 1.Department of Orthopaedic Surgery, School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8641, JapanJP

Personalised recommendations