XXXX associated with @entity4434 : clinical and diagnostic features.

@entity1 @entity644 @entity1643 @entity4772 @entity10692 @entity174 @entity706 @entity454 @entity3157 @entity3528 @entity177 @entity79 @entity520 @entity1391 @entity1582 @entity803 @entity460 @entity74 @entity4434 @entity560
OBJECTIVE: @entity4772 associated with adult acquired @entity4434 is thought to result from hypophosphataemia and relative @entity10692 deficiency. We have followed the clinical and diagnostic features of @entity1 with @entity4772 associated with @entity4434 , with particular emphasis on their responses to treatment with @entity460 , @entity1391 and @entity560 . DESIGN: Retrospective Mayo Clinic case-note review from 1975 to 1994 and prospective follow-up study, combined with literature review. @entity1 : Eleven @entity1 (7 male, 4 female) were identified who satisfied criteria for diagnosis of @entity4772 and @entity4434 . Twenty-five additional @entity1 were identified in a literature review from 1954 to the present. METHODS: Clinical history and physical examination, serum and urine bone and mineral parameter, X-ray radiography and iliac crest bone histomorphometry. RESULTS: All @entity1 presented with typical symptoms of @entity4772 , including lower extremity or @entity1643 , and all had @entity174 , pseudofractures, and/or @entity79 on X-ray radiography. @entity4772 and @entity4434 were diagnosed concurrently in 10 @entity1 , whereas @entity4772 preceded diagnosis of @entity4434 by 5 years in one @entity1 . Pre-treatment bone biopsies in 9 of the 11 @entity1 demonstrated increased osteoid surface, volume and width. In the one @entity1 labelled with @entity803 prior to biopsy, mineralization lag time was prolonged at 111 days (normal 19.2 +/- 1.0 days). Hypophosphataemia, inappropriately low @entity10692 levels, @entity177 , and @entity520 due to @entity3157 leak and uraemia, contributed to the @entity4772 in these @entity1 . @entity3528 was present in two @entity1 . Eight of the 11 @entity1 with @entity4772 associated with @entity4434 had @entity74 , including multiple @entity1582 or @entity706 , many of them manifest by light-chain @entity644 . Over a mean @entity1 follow-up period of 46 months (range 1-239 months), @entity1 responded symptomatically to @entity460 , @entity1391 , and @entity560 replacement typically within 1-6 months. In 8 @entity1 in whom follow-up data were available, post-treatment serum @entity1391 and @entity10692 levels improved in the setting of stable mild @entity177 ; only one @entity1 developed @entity454 after 20 years, suggesting that these @entity1 do not invariably progress rapidly to @entity177 . CONCLUSIONS: Regardless of the underlying cause, @entity4772 associated with adult acquired @entity4434 appears to respond well to @entity460 , @entity1391 , and @entity560 replacement. These @entity1 do not appear to necessarily require @entity10692 replacement.
