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    Glycaemia and phosphatemia after oral glucose and maltitol ingestion in subjects from two different race groups: preliminary evidence of inter-race differences in metabolism and possible implications for urinary stone disease.
    Int Urol Nephrol 2017 May 19. Epub 2017 May 19.
    Department of Chemistry, University of Cape Town, Rondebosch, Cape Town, 7701, South Africa.
    Purpose: Glucose (Glu) and maltitol (Mal) ingestion affect calciuria and phosphaturia. Renal phosphate leak involving hypophosphatemia is thought to be a mechanism. Inter-race differences in carbohydrate metabolism are known. Read More

    Analysis of Hypo- and Hyperphosphatemia in an Intensive Care Unit Cohort.
    Anesth Analg 2017 Jun;124(6):1897-1905
    From the *Skåne University Hospital, Lund, Getingevägen 4, SE-22185 Lund, Sweden; and †Science & Registry Nordic, Annedalsvägen 9, SE-22764 Lund, Sweden.
    Background: Blood phosphate levels are vulnerable to fluctuations and changes in phosphate levels are often neglected. The aim of this study was to evaluate whether deviations in phosphate levels correlate to higher 180-day overall mortality or morbidity.

    Methods: Four thousand six hundred fifty-six patients with 19,467 phosphate values treated at the adult intensive care unit at Skåne University Hospital, Lund, Sweden during 2006-2014 were retrospectively divided into a control group and 3 study groups: hypophosphatemia, hyperphosphatemia, and a mixed group showing both hypo/hyperphosphatemia. Read More

    KIT Inhibition by Imatinib in Patients with Severe Refractory Asthma.
    N Engl J Med 2017 05;376(20):1911-1920
    From Brigham and Women's Hospital, Harvard Medical School, Boston (K.N.C., H.R.K., J.C., J.L., A.C.-T., D.G., T.M.L., J.A.B., E.I.), and Novartis Institutes for BioMedical Research, Cambridge (S.K.) - both in Massachusetts; Washington University, St. Louis (M.C.); University of Wisconsin, Madison (N.J.); Columbia University Medical Center, New York (E.D.); Cleveland Clinic, Cleveland (S.E.); University of Alabama at Birmingham, Birmingham (J.L.T.); Temple University, Philadelphia (K.S.), and Pennsylvania State University, Hershey (V.M.C.) - both in Pennsylvania; and National Jewish Health, Denver (M.E.W.).
    Background: Mast cells are present in the airways of patients who have severe asthma despite glucocorticoid treatment; these cells are associated with disease characteristics including poor quality of life and inadequate asthma control. Stem cell factor and its receptor, KIT, are central to mast-cell homeostasis. We conducted a proof-of-principle trial to evaluate the effect of imatinib, a KIT inhibitor, on airway hyperresponsiveness, a physiological marker of severe asthma, as well as on airway mast-cell numbers and activation in patients with severe asthma. Read More

    Growth hormone therapy for a patient with idiopathic Fanconi syndrome and growth hormone deficiency.
    CEN Case Rep 2017 May 9;6(1):85-87. Epub 2017 Feb 9.
    Department of Pediatrics, Hokkaido University Hospital, N15, W7, Sapporo, 060-8638, Japan.
    Idiopathic Fanconi syndrome (FS) is characterized by a generalized dysfunction of the renal proximal tubules. Patients with FS often exhibit growth retardation due to complex factors, such as hypophosphatemia, metabolic acidosis, disturbed vitamin D metabolism and hypokalemia. To date, one FS patient has been reported to exhibit growth failure due to growth hormone deficiency (GHD), but the long-term clinical course of recombinant human GH (rhGH) therapy has not been reported. Read More

    Serum calcitriol levels in a patient with X-linked hypophosphatemia complicated by autosomal dominant polycystic kidney disease.
    CEN Case Rep 2017 May 22;6(1):29-35. Epub 2016 Oct 22.
    Department of Pediatrics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan.
    Serum calcitriol [1,25(OH)2D] levels are low normal in the presence of hypophosphatemia in X-linked dominant hypophosphatemic rickets (XLH) due to elevated serum fibroblast growth factor 23 (FGF23) levels. We report a peculiar finding of markedly elevated serum 1,25(OH)2D levels in a patient with XLH complicated by autosomal dominant polycystic kidney disease (ADPKD) and retinitis pigmentosa (RP). She was diagnosed with XLH, ADPKD and RP at the age of 5, 13 and 15 years, respectively. Read More

    Cinacalcet in hyperparathyroidism management after pediatric renal transplantation.
    CEN Case Rep 2016 Nov 22;5(2):141-143. Epub 2016 Jan 22.
    Pediatric Nephrology Department, Robert Debré Hospital, 48 Boulevard Sérurier, 75019, Paris, France.
    Secondary hyperparathyroidism is often associated with end stage renal disease; even after renal transplantation, hyperparathyroidism may persist, and is responsible for hypercalcemia, hypophosphatemia and elevated parathyroid hormone (iPTH) levels. Parathyroid hyperplasia is frequently associated with persistent hyperparathyroidism, and may require a surgical treatment. Here, we report hyperparathyroidism along with parathyroid hyperplasia in a 7-year-old child, which persisted after renal transplant. Read More

    Dental management of patients with X-linked hypophosphatemia.
    Restor Dent Endod 2017 May 6;42(2):146-151. Epub 2017 Jan 6.
    Department of Conservative Dentistry, School of Dentistry and Dental Science Research Institute, Chonnam National University, Gwangju, Korea.
    X-linked hypophosphatemia (XLH) is a hereditary metabolic disease caused by the loss of phosphate through the renal tubules into the urine, and an associated decrease in serum calcium and potassium phosphate. Its dental features include spontaneous dental abscesses that occur in the absence of trauma or dental caries. The aim of this case report was to describe the dental problems of XLH patients and to evaluate limitations in their treatment. Read More

    Cardiovascular consequences of hypophosphatemia.
    Panminerva Med 2017 May 12. Epub 2017 May 12.
    Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii.
    Introduction: Few studies have been conducted to evaluate the effect of hypophosphatemia on cardiovascular consequences. The goal of this review was to determine whether hypophosphatemia is associated with cardiovascular consequences and to increase its awareness as a new clinical entity and a reversible cause of cardiovascular consequences.

    Evidence Acquisition: We searched MEDLINE and PubMed through September 2016 for primary studies that reported the relationship between hypophosphatemia and cardiovascular consequences including cardiomyopathy and arrhythmia. Read More

    Hypophosphatemia after nontraumatic intracranial hemorrhage.
    Acta Anaesthesiol Scand 2017 May 11. Epub 2017 May 11.
    Department Anesthesiology, Division of Intensive Care Medicine, Oulu University Hospital, Medical Research Center Oulu, Research Group of Surgery, Anesthesia and Intensive Care, Medical Faculty, University of Oulu, Oulu, Finland.
    Background: The aim of this study was to assess the incidence and contributing factors of hypophosphatemia and the association with poor long-term outcome after nontraumatic intracranial hemorrhage.

    Methods: This was a prospective, observational study of patients with nontraumatic intracranial hemorrhage (i.e. Read More

    Fractures and Osteomalacia in a Patient Treated With Frequent Home Hemodialysis.
    Am J Kidney Dis 2017 May 9. Epub 2017 May 9.
    Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA.
    Bone deformities and fractures are common consequences of renal osteodystrophy in the dialysis population. Persistent hypophosphatemia may be observed with more frequent home hemodialysis regimens, but the specific effects on the skeleton are unknown. We present a patient with end-stage renal disease treated with frequent home hemodialysis who developed severe bone pain and multiple fractures, including a hip fracture and a tibia-fibula fracture complicated by nonunion, rendering her nonambulatory and wheelchair bound for more than a year. Read More

    Tumour genesis syndrome: severe hypophosphatemia and hypokalemia may be ominous presenting findings in childhood acute myeloid leukaemia.
    Eur J Pediatr 2017 May 4. Epub 2017 May 4.
    Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong, SAR, Hong Kong.
    We report a 16-year-old girl who was diagnosed with acute leukaemia and a marked leucocytosis >200 × 10(9)/L. She presented with marked hypophosphatemia, hypokalemia, acute renal failure and acute respiratory failure. These electrolytes disturbances may indicate rapid tumour genesis. Read More

    Effective localization in tumor-induced osteomalacia using (68)Ga-DOTATOC-PET/CT, venous sampling and 3T-MRI.
    Endocrinol Diabetes Metab Case Rep 2017 19;2017. Epub 2017 Apr 19.
    The First Department of Medicine.
    Summary: Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome characterized by renal phosphate wasting leading to hypophosphatemia due to excessive actions of fibroblast growth factor 23 (FGF23) produced by the tumors. Although the best way of curing TIO is complete resection, it is usually difficult to detect the culprit tumors by general radiological modalities owing to the size and location of the tumors. We report a case of TIO in which the identification of the tumor by conventional imaging studies was difficult. Read More

    Gonadotrophin abnormalities in an infant with Lowe syndrome.
    Endocrinol Diabetes Metab Case Rep 2017 19;2017. Epub 2017 Apr 19.
    Departments of Paediatric Endocrinology and Diabetes.
    Summary: This case, presenting with bilateral impalpable testes, illustrates the relevance of a broad differential disorders of sex development case management. It provides new insights on hypothalamic-pituitary-gonadal (HPG) axis and testicular function abnormalities in the multisystem disorder of Lowe syndrome. Lowe syndrome, also known as oculocerebrorenal syndrome, is a rare disorder characterised by eye abnormalities, central nervous system involvement and proximal renal tubular acidosis. Read More

    Osmotic Demyelination Syndrome in a Eunatremic Patient with Chronic Kidney Disease.
    J Assoc Physicians India 2017 Mar;65(3):98-99
    Junior Resident, Department of Medicine, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh.
    Osmotic demyelination syndrome is classically associated with rapid correction of hyponatremia. However, it can occur in normonatremic patients with other electrolyte abnormalities. One must suspect osmotic demyelination syndrome in susceptible patients with other electrolyte abnormalities like hypokalemia and hypophosphatemia. Read More

    Severe Hypophosphatemia Following Denosumab Administration in a Hemodialysis Patient with Progressive Prostate Cancer.
    Urol Case Rep 2017 Jul 26;13:63-65. Epub 2017 Apr 26.
    Department of Urology, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara, Chiba 299-0111, Japan.
    In a 68-year-old man on maintenance hemodialysis (HD), severe anemia was detected. Bone marrow biopsy was performed for investigation of pancytopenia and pathological examination revealed adenocarcinoma of the prostate. Prostate specific antigen (PSA) was 574 ng/mL. Read More

    Octreotide is Ineffective in Treating Tumor-Induced Osteomalacia; Results of a Short-Term Therapy.
    J Bone Miner Res 2017 Apr 29. Epub 2017 Apr 29.
    Skeletal Clinical Studies Unit, Craniofacial and Skeletal Disease Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA.
    Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome in which unregulated hypersecretion of fibroblast growth factor 23 (FGF23) by phosphaturic mesenchymal tumors (PMT) causes renal phosphate wasting, hypophosphatemia, and osteomalacia. The resulting mineral homeostasis abnormalities and skeletal manifestations can be reversed with surgical resection of the tumor. Unfortunately, PMTs are often difficult to locate, and medical treatment with oral phosphate and vitamin D analogues is either insufficient to manage the disease or not tolerated. Read More

    Clinical and Biochemical Characteristics of Exertional Heat Stroke among Paratroopers in Agra, India.
    J Assoc Physicians India 2017 Feb;65(2):57-61
    Consultant Pathologist, Department of Internal Medicine, Military Hospital, Agra Cantt., Uttar Pradesh.
    Objective: The purpose of this study was to assess the clinical profile, biochemical parameters and outcome in a series of 78 patients of heat stroke admitted and treated in a military hospital in India.

    Methods: This was a prospective study in a military hospital. A total of 78 patients of exertional heat stroke admitted and treated over more than 2 years are reported. Read More

    Severe hypercalcaemia and hypophosphataemia with an optimised preterm parenteral nutrition formulation in two epochs of differing phosphate supplementation.
    Arch Dis Child Fetal Neonatal Ed 2017 Apr 29. Epub 2017 Apr 29.
    Neonatal Intensive Care Unit, Jenny Lind Children's Hospital, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK.
    Objective: To compare in two epochs of differing phosphate provision serum calcium, phosphate, potassium, and sodium concentrations and the frequency of abnormality of these electrolytes and of sepsis in preterm infants who received an optimised higher amino acid-content formulation.

    Design And Setting: Retrospective cohort study at a single tertiary-level neonatal unit.

    Patients: Preterm infants given parenteral nutrition (PN) in the first postnatal week during two discrete 6-month epochs in 2013-2014. Read More

    Phase 1b study of galunisertib in combination with gemcitabine in Japanese patients with metastatic or locally advanced pancreatic cancer.
    Cancer Chemother Pharmacol 2017 Jun 27;79(6):1169-1177. Epub 2017 Apr 27.
    National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan.
    Purpose: Transforming growth factor-beta inhibitors may enhance the antitumor activity of gemcitabine with acceptable safety and tolerability. This open-label, multicenter, non-randomized phase 1b study assessed the safety/tolerability, pharmacokinetics, and tumor response of galunisertib plus gemcitabine in Japanese patients with advanced or metastatic pancreatic cancer.

    Methods: During each 28-day cycle, galunisertib 150 mg was administered orally twice daily (300 mg/day) for 14 days, followed by 14 days of rest. Read More

    The diagnostic dilemma of tumor induced osteomalacia: a retrospective analysis of 144 cases.
    Endocr J 2017 Apr 26. Epub 2017 Apr 26.
    Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
    Diagnostic delay of tumor induced osteomalacia (TIO) is common in clinic practice. To investigate the diagnostic condition of TIO in China and raise clinicians' awareness of TIO, we retrospectively analyzed clinical manifestations, biochemical features, and specially evaluated missed diagnoses and misdiagnoses among 144 TIO patients from Peking Union Medical College Hospital during December 1982 to December 2014. Clinical presentations of TIO mainly included bone pain, difficulty in walking, pathological fractures, muscle weakness, and height loss. Read More

    Phase 1 dose-escalation study of mirvetuximab soravtansine (IMGN853), a folate receptor α-targeting antibody-drug conjugate, in patients with solid tumors.
    Cancer 2017 Apr 25. Epub 2017 Apr 25.
    Gillette Center for Gynecologic Oncology, Massachusetts General Hospital, Boston, Massachusetts.
    Background: Mirvetuximab soravtansine (IMGN853) is an antibody-drug conjugate that selectively targets folate receptor α (FRα). In this phase 1 dose-escalation study, the authors investigated IMGN853 in patients with FRα-positive solid tumors.

    Methods: Patients received IMGN853 on day 1 of a 21-day cycle (once every 3 weeks dosing), with cycles repeated until patients experienced dose-limiting toxicity or progression. Read More

    Phosphate imbalance in patients with heart failure.
    Heart Fail Rev 2017 May;22(3):349-356
    Department of Internal Medicine, School of Medicine, University of Ioannina, 451 10, Ioannina, Greece.
    Patients with heart failure often exhibit electrolyte abnormalities, such as hyponatremia or hypokalemia/hyperkalemia. Although not as common as the other electrolyte disturbances observed in patients with heart failure, phosphate imbalance is also of high importance in this population. The aim of this review is to present the mechanisms of low or high phosphate serum levels in patients with heart failure and its role in the pathogenesis and progression of heart dysfunction. Read More

    Management of mineral and bone disorders in renal transplant recipients.
    Nephrology (Carlton) 2017 Mar;22 Suppl 2:65-69
    Department of Endocrinology, Monash Health, Melbourne, Australia.
    The management of post-transplantation bone disease is a complex problem that remains under-appreciated in clinical practice. In these patients, pre-existing metabolic bone disorder is further impacted by the use of immunosuppressive medications (glucocorticoids and calcineurin-inhibitors), variable post-transplantation renal allograft function and post-transplantation diabetes mellitus. The treatment of post-transplantation bone loss should begin pre-transplantation. Read More

    Iron-induced hypophosphatemia: an emerging complication.
    Curr Opin Nephrol Hypertens 2017 Apr 8. Epub 2017 Apr 8.
    aDepartment of Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism bDepartment of Radiology, Medical University of Innsbruck, Innsbruck, Austria.
    Purpose Of Review: Iron-induced hypophosphatemia is a well documented side-effect but associated complications are largely neglected, because the results from single dosing studies suggest that transient decreases in plasma phosphate concentrations are asymptomatic and fully reversible. However, an increasing number of case reports and case series suggest that some patients develop severe and symptomatic hypophosphatemia. Long-term complications from hypophosphatemia include osteomalacia and bone fractures, which can result from repeated intravenous administration of certain high-dose iron preparations. Read More

    [Identification of a novel splicing mutation of PHEX gene in a pedigree affected with X-linked hypophosphatemia].
    Zhonghua Yi Xue Yi Chuan Xue Za Zhi 2017 Apr;34(2):216-219
    Center for Reproductive Medicine, Shandong University, National Research Center for Assisted Reproductive Technology and Reproductive Genetics, The Key Laboratory for Reproductive Endocrinology of Ministry of Education, Jinan, Shandong 250000, China.
    Objective: To identify potential mutation of PHEX gene in two patients from a family affected with X-linked hypophosphatemia (XLH).

    Methods: PCR and Sanger sequencing were performed on blood samples from the patients and 100 healthy controls. Reverse transcription-PCR (RT-PCR) was used to determine the mRNA expression in patient samples. Read More

    Mutational analysis of PHEX, FGF23 and CLCN5 in patients with hypophosphataemic rickets.
    Clin Endocrinol (Oxf) 2017 Apr 6. Epub 2017 Apr 6.
    Department of Genetics, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
    Context: Hypophosphataemic rickets (HR) is a group of rare hereditary renal phosphate wasting disorders caused by mutations in PHEX, FGF23, DMP1, ENPP1, CLCN5 or SLC34A3.

    Objective: To investigate underlying genetic defects in patients with hypophosphataemic rickets.

    Methods: We analysed genomic DNA from nine unrelated families for mutations in the entire coding region of PHEX, FGF23, DMP1, ENPP1, CLCN5 or SLC34A3 by PCR sequencing and copy number analysis. Read More

    Serum 25-Hydroxyvitamin D Insufficiency in Search of a Bone Disease.
    J Clin Endocrinol Metab 2017 Mar 30. Epub 2017 Mar 30.
    Department of Endocrinology, Austin Health, University of Melbourne.
    Introduction: Vitamin D 'insufficiency' and 'deficiency' are defined as a serum 25-hydroxyvitamin D (25(OH)D) below 75 and 30 nmol/L respectively. We aimed to determine whether these values signal hypocalcaemia and hypophosphatemia, secondary hyperparathyroidism, high bone remodeling, low areal bone mineral density (aBMD), microstructural deterioration, or reduced matric mineralization density (MMD), and so suggest whether bone fragility is present.

    Method: Concentrations of 25(OH)D, calcium, phosphate, creatinine and parathyroid hormone (PTH) were measured in 11,855 subjects. Read More

    The metabolic bone disease associated with the Hyp mutation is independent of osteoblastic HIF1α expression.
    Bone Rep 2017 Jun 17;6:38-43. Epub 2017 Jan 17.
    Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN 46202, United States.
    Fibroblast growth factor-23 (FGF23) controls key responses to systemic phosphate increases through its phosphaturic actions on the kidney. In addition to stimulation by phosphate, FGF23 positively responds to iron deficiency anemia and hypoxia in rodent models and in humans. The disorder X-linked hypophosphatemia (XLH) is characterized by elevated FGF23 in concert with an intrinsic bone mineralization defect. Read More

    Hungry bone syndrome.
    Curr Opin Nephrol Hypertens 2017 Apr 1. Epub 2017 Apr 1.
    aDivision of Nephrology, University of Arkansas for Medical Sciences bCentral Arkansas Veterans Affairs Healthcare System, Little Rock, Arkansas cOffice of Education, Central Alabama Veterans Healthcare System, Montgomery, Alabama, USA.
    Purpose Of Review: In the United States, the number of parathyroidectomies among patients with chronic dialysis has remained stable in the last decade. A fall in serum calcium concentration is common postparathyroidectomy in patients with hyperparathyroidism, which usually resolves in 2-4 days. A severe drop in serum total calcium concentration less than 2. Read More

    Recurrent persistent hypophosphatemia in a male-to-female transgender patient with anorexia nervosa: Case report.
    Int J Eat Disord 2017 Mar 28. Epub 2017 Mar 28.
    Eating Recovery Center, Denver, Colorado.
    Refeeding hypophosphatemia remains a serious and common complication during the early phases of nutritional rehabilitation and weight restoration for patients with anorexia nervosa. Typically, the risk of refeeding hypophosphatemia diminishes after the first 1-2 weeks of the refeeding process and thus, frequent monitoring serum phosphorus levels becomes less important as refeeding proceeds. Herein, we describe a case of persistent recurrent hypophosphatemia in a male-to-female transgender patient with severe anorexia nervosa. Read More

    A safe and effective multi-day colonoscopy bowel preparation for individuals with spinal cord injuries.
    J Spinal Cord Med 2017 Apr 1:1-8. Epub 2017 Apr 1.
    a Spinal Cord Injury Service , Veterans Affairs Puget Sound Health Care System , Seattle , WA , USA.
    Context/objective: Colonoscopy with polypectomy is associated with a reduced risk of colorectal cancer (CRC), but poor bowel cleansing limits the diagnostic yield of the procedure. Patients with spinal cord injury (SCI) frequently have suboptimal bowel cleansing with standard pre-colonoscopy bowel preparation regimens. We aimed to assess the safety, tolerability, and efficacy of a multi-day inpatient bowel preparation regimen in a population of patients with SCI. Read More

    The medical risks of severe anorexia nervosa during initial re-feeding and medical stabilisation.
    Clin Nutr ESPEN 2017 Feb 21;17:92-99. Epub 2016 Oct 21.
    Anorexia Nervosa Intensive Treatment Team (ANITT), Royal Edinburgh Hospital, 6th Floor Kennedy Tower, Morningside Terrace, Edinburgh, EH10 5HF, UK; Department of Psychiatry, University of Edinburgh, Kennedy Tower, Morningside Terrace, Edinburgh, EH10 5HF, UK. Electronic address:
    Background & Aims: Objective evidence about the risks associated with anorexia nervosa and how to manage them, is limited. The aim of this study is to describe the medical risk profile, management and outcomes of a cohort of patients with severe anorexia nervosa (sAN) during medical stabilisation treatment.

    Methods: Retrospective analysis of case records gathered medical risk data for a 90 day high risk period, on 65 patients with sAN admitted to two specialist services. Read More

    Persistent arthralgia, vomiting and hypercalcemia as the initial manifestations of hyperthyroidism: A case report.
    Mol Clin Oncol 2017 Feb 10;6(2):258-260. Epub 2017 Jan 10.
    Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China.
    A 53-year-old woman presented with persistent edema and pain of the metacarpophalangeal and proximal interphalangeal joints and the wrist, knee and ankle joints, with more recent intermittent nausea and vomiting. Treatment for rheumatoid arthritis and osteoarthritis was ineffective. No clinical manifestations typical of hyperthyroidism were observed. Read More

    Adult-onset hypophosphatemic osteomalacia associated with Sjogren syndrome: Clinical case report.
    Medicine (Baltimore) 2017 Mar;96(13):e6493
    aDepartment of Nuclear Medicine, West China Hospital of Sichuan University bDepartment of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
    Rationale: Hypophosphatemic osteomalacia (HO) is a metabolic bone disease, exhibiting different etiologies such as genetic mutation, tumor induction, dysimmunity, or renal disease. Sjogren's syndrome (SS) is a connective tissue disorder commonly involving exocrine glands; however kidney involvement is also encountered, leading to abnormal phosphorus metabolism, even HO.

    Patient Concerns: A 47-year-old female patient presented progressively worsening pain in the chest wall, back and bilateral lower extremities as well as muscle weakness was referred to our department. Read More

    Extended Stability of Sodium Phosphate Solutions in Polyvinyl Chloride Bags.
    Can J Hosp Pharm 2017 Jan-Feb;70(1):7-12. Epub 2017 Feb 28.
    , MScPhm, is Director of Pharmacy, Sunnybrook Health Sciences Centre, and Associate Professor, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario.
    Background: Sodium phosphate injection is used to treat moderate to severe hypophosphatemia. There have been no published reports documenting the physical compatibility or chemical stability of sodium phosphate injection in IV solutions.

    Objective: To evaluate the physical compatibility and chemical stability of 30 and 150 mmol/L solutions of phosphate, prepared from sodium phosphate injection, in 5% dextrose in water (D5W) and in 0. Read More

    Tumor-induced osteomalacia: experience from a South American academic center.
    Osteoporos Int 2017 Mar 25. Epub 2017 Mar 25.
    Departamento de Endocrinología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Cuarto piso, Santiago, Chile.
    The majority of tumor-induced osteomalacia cases have been reported in the Northern Hemisphere and Asia. In this first series of South American patients, we show that the clinical presentation and sensitivity of plasmatic fibroblast growth factor 23 and somatostatin analog-based imaging are similar to those described in other populations.

    Introduction: Describe the experience of clinical presentation, diagnostic study, and treatment of patients with tumor-induced osteomalacia (TIO) in a South American academic center in comparison to literature. Read More

    Denosumab in advanced/unresectable giant-cell tumour of bone (GCTB): For how long?
    Eur J Cancer 2017 May 17;76:118-124. Epub 2017 Mar 17.
    Sarcoma Oncology Center, Santa Monica, CA, USA.
    Background: Giant-cell tumours of bone (GCTB) are RANK/RANK-ligand (RANKL) positive, aggressive and progressive osteolytic tumours. Denosumab, a RANKL inhibitor, was FDA-approved for adults and skeletally mature adolescents with unresectable GCTB or when surgical resection is likely to result in severe morbidity. Data on long-term toxicity and activity of denosumab monthly 'GCTB-schedule' (120 mg per 12/year, 1440 mg total dose/year) are lacking. Read More

    The PARP Inhibitor Veliparib Can Be Safely Added to Bendamustine and Rituximab and Has Preliminary Evidence of Activity in B-Cell Lymphoma.
    Clin Cancer Res 2017 Mar 17. Epub 2017 Mar 17.
    Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, New York.
    Purpose: The PARP inhibitor veliparib enhances the cytotoxicity of alkylating agents. This phase I study evaluated veliparib with the bifunctional alkylator bendamustine (VB) in patients with relapsed/refractory lymphoma, multiple myeloma, and solid malignancies, with a cohort expansion of VB with rituximab (VBR) in patients with B-cell lymphomas.Experimental Design: This dose-escalation study evaluated safety, pharmacokinetics, and preliminary efficacy of veliparib (20-400 mg twice a day, days 1-7 of 28-day cycle) and bendamustine (70 and 90 mg/m(2) intravenously, days 1 and 2). Read More

    Severe hypophosphataemia after intravenous iron administration.
    BMJ Case Rep 2017 Mar 13;2017. Epub 2017 Mar 13.
    Division of Endocrinology, University Hospital Zürich, Zürich, Switzerland.
    Iron deficiency is common and can be effectively treated with parenteral iron infusion. We report a case of an iron-deficient and vitamin D-deficient woman who developed severe symptomatic hypophosphataemia following intravenous ferric carboxymaltose administration. We stress the need of increased awareness of this potential complication among physicians. Read More

    Bone fracture in severe small-for-gestational-age, extremely low birth weight infants: A single-center analysis.
    Early Hum Dev 2017 Mar - Apr;106-107:75-78. Epub 2017 Mar 7.
    Division of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Japan.
    Introduction: Bone fracture is a complication of extremely low birth weight infants (ELBWIs). This study aimed to analyze risk factors for bone fracture in a population of severe small-for-gestational-age (SGA) ELBWIs.

    Methods: We retrospectively studied data from ELBWIs with a birth weight <1000g and <-2 standard deviations (SDs) born at the National Center for Child Health and Development, Japan, from 2013 to 2015. Read More

    Ferric carboxymaltose-induced hypophosphataemia after kidney transplantation.
    Neth J Med 2017 Mar;75(2):65-73
    Department of Internal Medicine, Division of Nephrology & Kidney Transplantation, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
    Background: Ferric carboxymaltose (FCM) can induce hypophosphataemia in the general population and patients with chronic kidney disease (CKD). Less is known about the effect of FCM in the kidney transplant population. It has been suggested that fibroblast growth factor 23 (FGF-23)-mediated renal phosphate wasting may be the most likely cause of this phenomenon. Read More

    Vitamin D Deficiency and a Blunted Parathyroid Hormone Response in Children with Attention-Deficit/Hyperactivity Disorder.
    Clin Lab 2017 Mar;63(3):435-443
    Background: Attention-deficit/hyperactivity disorder (ADHD) is the most frequently diagnosed neuropsychiatric disorder of childhood. The etiopathogenesis of ADHD has not been fully defined. Recent evidence has suggested a pathophysiological role of vitamin D deficiency in ADHD. Read More

    Hypophosphatemia: nutritional status, body composition, and mortality in hemodialysis patients.
    Int Urol Nephrol 2017 Mar 6. Epub 2017 Mar 6.
    Nephrocare, Faro, Portugal.
    Purpose: The aim of the present study was to investigate the relationship between serum phosphate levels, clinical parameters, body composition, and mortality.

    Methods: Multicenter longitudinal observational study of a cohort of 3552 patients in hemodialysis (HD) from 34 Nephrocare dialysis units in Portugal with 24 months of follow-up. Patients were divided into three groups depending on their serum phosphorus (<3. Read More

    Outcomes of an inpatient medical nutritional rehabilitation protocol in children and adolescents with eating disorders.
    J Eat Disord 2017 1;5. Epub 2017 Mar 1.
    The University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania USA.
    Background: Medical stabilization through inpatient nutritional rehabilitation is often necessary for patients with eating disorders (EDs) but includes the inherent risk of refeeding syndrome. Here we describe our experience of implementing and sustaining an inpatient nutritional rehabilitation protocol designed to strategically prepare patients with EDs and their families for discharge to a home setting in an efficient and effective manner from a general adolescent medicine unit. We report outcomes at admission, discharge, and 4-weeks follow-up. Read More

    Multiple Electrolyte and Metabolic Emergencies in a Single Patient.
    Case Rep Nephrol 2017 31;2017:4521319. Epub 2017 Jan 31.
    Olive View-UCLA Medical Center, 14445 Olive View Drive, 2B-182, Sylmar, CA 91342, USA.
    While some electrolyte disturbances are immediately life-threatening and must be emergently treated, others may be delayed without immediate adverse consequences. We discuss a patient with alcoholism and diabetes mellitus type 2 who presented with volume depletion and multiple life-threatening electrolyte and metabolic derangements including severe hyponatremia (serum sodium concentration [SNa] 107 mEq/L), hypophosphatemia ("undetectable," <1.0 mg/dL), and hypokalemia (2. Read More

    Tumor-induced Osteomalacia Caused by a Parotid Tumor.
    Intern Med 2017 1;56(5):535-539. Epub 2017 Mar 1.
    Division of Nephrology and Endocrinology, The University of Tokyo Hospital, Japan.
    A 77-year-old man was suspected of having tumor-induced osteomalacia (TIO) because of hypophosphatemia (1.9 mg/dL) and elevated serum fibroblast growth factor 23 (FGF23) level (186.9 pg/mL). Read More

    Thiamin and folic acid deficiency accompanied by resistant electrolyte imbalance in the re-feeding syndrome in an elderly patient.
    Asia Pac J Clin Nutr 2017 Mar;26(2):379-382
    Department of Internal Medicine, Istanbul Umraniye Training and Research Hospital, Turkey.
    Introduction: Re-feeding Syndrome (RS) is a deadly complication, which can be encountered during "refeeding" of malnourished patients. In these patients, thiamin deficiency may develop and "risk awareness" is the most significant factor in the management of these patients. In this case report, the treatment is presented of an elderly patient who was diagnosed with RS and followed-up in the intensive care unit (ICU) due to resistant fluidelectrolyte imbalance. Read More

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