Hypophosphatemic Rickets.

Martin Bitzan, Paul R Goodyer

Journal: Pediatric clinics of North America 2019;66(1):179-207

PMID: 30454743

Full Text on Elsevier Science View on PubMed

Abstract

Hypophosphatemic rickets, mostly of the X-linked dominant form caused by pathogenic variants of the PHEX gene, poses therapeutic challenges with consequences for growth and bone development and portends a high risk of fractions and poor bone healing, dental problems and nephrolithiasis/nephrocalcinosis. Conventional treatment consists of PO4 supplements and calcitriol requiring monitoring for treatment-emergent adverse effects. FGF23 measurement, where available, has implications for the differential diagnosis of hypophosphatemia syndromes and, potentially, treatment monitoring. Newer therapeutic modalities include calcium sensing receptor modulation (cinacalcet) and biological molecules targeting FGF23 or its receptors. Their long-term effects must be compared with those of conventional treatments.

Address: Department of Pediatrics, The Montreal Children's Hospital, McGill University Health Centre, 1001 Boulevard Décarie, Room B RC.6164, Montreal, Quebec H4A 3J1, Canada. Electronic address: [email protected].; The Research Institute of the McGill University Health Centre, 1001 Boulevard Décarie, Room EM1.2232, Montreal, Quebec H4A3J1, Canada.

DOI: 10.1016/j.pcl.2018.09.004

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MeSH Terms: Calcimimetic Agents, Child, Diagnosis, Differential, Fibroblast Growth Factor-23, Growth Hormone, Humans, Mutation, Phosphates, Rickets, Hypophosphatemic, Vitamin D