An unusual case of familial hypophosphatemic rickets

Authors

  • Leny E. Bhadke Department of Pediatrics, B. K. L. Walawalkar Medical College, Sawarde, Ratnagiri, Maharashtra,
  • Suryakant Y. Ingale Department of Pediatrics, B. K. L. Walawalkar Medical College, Sawarde, Ratnagiri, Maharashtra,
  • Prathamesh S. Shinde Department of Pediatrics, B. K. L. Walawalkar Medical College, Sawarde, Ratnagiri, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20230449

Keywords:

Rickets, Hypophosphatemic Rickets, PHEX gene, Bone deformities

Abstract

Rickets is the failure of mineralisation of osteoid and newly formed bones in a child skeleton. It is commonly associated with vitamin D deficiency; however, it can be because of a decrease in serum phosphate level leading to inadequate mineralization of cartilage and bone, consequent skeletal deformities and growth retardation. In hypophosphatemic rickets, there are both inherited and acquired forms, where X-linked hypophosphatemic rickets (XLH) is the most prevalent genetic form and caused by mutations in the phosphate-regulating endopeptidase (PHEX) gene. XLH is associated with growth retardation and bone deformities. This rare variety was diagnosed in a 2 year 4 month old child who had brought by parents with complaint of abnormal gait. In the present case, clinical and radiographic aspects of manifestation of familial hypophosphatemic rickets are discussed.

References

Raeder H, Shaw N, Netelenbos C, Bjerknes R. A case of X-linked hypophosphatemic rickets: complications and the therapeutic use of cinacalcet. Eur J Endocrinol. 2008;159(1):S101-5.

Juneja H, Yadav M, Pahuja I. X-Linked hypophosphatemic rickets: A case report. Int J Curr Res. 2017;9(08):56598-600.

Naderi AS, Reilly RF. Hereditary disorders of renal phosphate wasting. Nat Rev Nephrol. 2010;6(11):657-65.

Quarles LD. Evidence for a bone-kidney axis regulating phosphate homeostasis. J Clin Invest. 2003;112(5):642-6.

Rowe PS. The molecular background to hypophosphataemic rickets. Arch Dis Child. 2000;83(3):192-4.

Cho HY, Lee BH, Kang JH, Ha IS, Cheong HI, Choi Y. A clinical and molecular genetic study of hypophosphatemic rickets in children. Pediatr Res. 2005;58(2):329-33.

Bielesz B, Klaushofer K, Oberbauer R. Renal phosphate loss in hereditary and acquired disorders of bone mineralization. Bone. 2004;35(6):1229-39.

Rowe PS. The wrickkened pathways of FGF23, MEPE and PHEX. Crit Rev Oral Biol Med. 2004;15(5):264-81.

Beur SM, Levine MA. Molecular pathogenesis of hypophosphatemic rickets. J Clin Endocrinol Metab. 2002;87(6):2467-73.

Saggese G, Baroncelli GI. Hypophosphataemic rickets. Horm Res. 2000;53(3):57-60.

Morris RC, Ives HE. Inherited disorders of the renal tubule. In: Brenner BM, eds. The Kidney. 5th ed. Philadelphia: WB Saunders Company; 1996: 1764-1827.

Portale AA, Halloran BP, Morris RC. Physiologic regulation of the serum concentration of 1,25-dihydroxyvitamin D by phosphorus in normal men. J Clin Invest. 1989;83(5):1494-9.

Econs MJ, Drezner MK. Bone disease resulting from inherited disorder of renal tubule transport and vitamin D metabolism. In: Coe FL, Favus MJ, eds. Disorder of Bone and Mineral Metabolism. New York: Raven Press; 1992: 935.

Costa T, Marie PJ, Scriver CR, Cole DE, Reade TM, Nogrady B, et al. X-linked hypophosphatemia: effect of calcitriol on renal handling of phosphate, serum phosphate, and bone mineralization. J Clin Endocrinol Metab. 1981;52(3):463-72.

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Published

2023-02-23

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Section

Case Reports