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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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Wolters Kluwer - Medknow
2019
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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. |
format | Online Article Text |
id | pubmed-6559118 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
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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