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An uncommon cause of polyarthralgia

Tumour induced osteomalacia (TIO) is a paraneoplastic syndrome characterized by renal phosphate wasting and hypophosphatemic osteomalacia, caused by FGF-23 (Fibroblast growth factor-23) producing mesenchymal tumours. Here, we report the case of a 40 year old lady referred by her family physician for...

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Autores principales: Soumya, Sudarsanababu Lalitha, Cherian, Kripa Elizabeth, Gupta, Riddhi Das, Poonnoose, Pradeep M., Hephzibah, Julie, Prabhu, Anne Jennifer, Paul, Thomas Vizhalil, Kapoor, Nitin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6559118/
https://www.ncbi.nlm.nih.gov/pubmed/31198764
http://dx.doi.org/10.4103/jfmpc.jfmpc_299_19
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author Soumya, Sudarsanababu Lalitha
Cherian, Kripa Elizabeth
Gupta, Riddhi Das
Poonnoose, Pradeep M.
Hephzibah, Julie
Prabhu, Anne Jennifer
Paul, Thomas Vizhalil
Kapoor, Nitin
author_facet Soumya, Sudarsanababu Lalitha
Cherian, Kripa Elizabeth
Gupta, Riddhi Das
Poonnoose, Pradeep M.
Hephzibah, Julie
Prabhu, Anne Jennifer
Paul, Thomas Vizhalil
Kapoor, Nitin
author_sort Soumya, Sudarsanababu Lalitha
collection PubMed
description Tumour induced osteomalacia (TIO) is a paraneoplastic syndrome characterized by renal phosphate wasting and hypophosphatemic osteomalacia, caused by FGF-23 (Fibroblast growth factor-23) producing mesenchymal tumours. Here, we report the case of a 40 year old lady referred by her family physician for multiple joint pains of 2 years duration. There was no evidence of inflammatory arthritis. Biochemical investigations revealed low phosphorus, with raised alkaline phosphatase and high levels of FGF-23. As a TIO was considered likely, functional imaging with a DOTATATE PET scan was done, which revealed a DOTA avid lesion in the right foot. Following surgical excision of the tumour, there was significant relief in symptoms and gradual recovery of phosphate to normal levels. It is relevant and important for family physicians as in subjects with symptom like polyarthralgia, a simple measurement of analytes like phosphate, calcium and alkaline phosphatase in primary care setting will help to arrive at a cause and referral for further evaluation as this condition is potentially treatable.
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spelling pubmed-65591182019-06-13 An uncommon cause of polyarthralgia Soumya, Sudarsanababu Lalitha Cherian, Kripa Elizabeth Gupta, Riddhi Das Poonnoose, Pradeep M. Hephzibah, Julie Prabhu, Anne Jennifer Paul, Thomas Vizhalil Kapoor, Nitin J Family Med Prim Care Case Report Tumour induced osteomalacia (TIO) is a paraneoplastic syndrome characterized by renal phosphate wasting and hypophosphatemic osteomalacia, caused by FGF-23 (Fibroblast growth factor-23) producing mesenchymal tumours. Here, we report the case of a 40 year old lady referred by her family physician for multiple joint pains of 2 years duration. There was no evidence of inflammatory arthritis. Biochemical investigations revealed low phosphorus, with raised alkaline phosphatase and high levels of FGF-23. As a TIO was considered likely, functional imaging with a DOTATATE PET scan was done, which revealed a DOTA avid lesion in the right foot. Following surgical excision of the tumour, there was significant relief in symptoms and gradual recovery of phosphate to normal levels. It is relevant and important for family physicians as in subjects with symptom like polyarthralgia, a simple measurement of analytes like phosphate, calcium and alkaline phosphatase in primary care setting will help to arrive at a cause and referral for further evaluation as this condition is potentially treatable. Wolters Kluwer - Medknow 2019-05 /pmc/articles/PMC6559118/ /pubmed/31198764 http://dx.doi.org/10.4103/jfmpc.jfmpc_299_19 Text en Copyright: © 2019 Journal of Family Medicine and Primary Care http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Case Report
Soumya, Sudarsanababu Lalitha
Cherian, Kripa Elizabeth
Gupta, Riddhi Das
Poonnoose, Pradeep M.
Hephzibah, Julie
Prabhu, Anne Jennifer
Paul, Thomas Vizhalil
Kapoor, Nitin
An uncommon cause of polyarthralgia
title An uncommon cause of polyarthralgia
title_full An uncommon cause of polyarthralgia
title_fullStr An uncommon cause of polyarthralgia
title_full_unstemmed An uncommon cause of polyarthralgia
title_short An uncommon cause of polyarthralgia
title_sort uncommon cause of polyarthralgia
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6559118/
https://www.ncbi.nlm.nih.gov/pubmed/31198764
http://dx.doi.org/10.4103/jfmpc.jfmpc_299_19
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