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Tytuł:
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Burosumab in tumor-induced osteomalacia: A case report.
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Autorzy:
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Day AL; Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, 1720 2nd Avenue South, FOT 839, 35294 Birmingham, AL, USA. Electronic address: .
Gutiérrez OM; Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, 35294 Birmingham, AL, USA.
Guthrie BL; Department of Neurosurgery, University of Alabama at Birmingham, 35294 Birmingham, AL, USA.
Saag KG; Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, 1720 2nd Avenue South, FOT 839, 35294 Birmingham, AL, USA.
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Źródło:
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Joint bone spine [Joint Bone Spine] 2020 Jan; Vol. 87 (1), pp. 81-83. Date of Electronic Publication: 2019 Aug 03.
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Typ publikacji:
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Case Reports; Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: Paris : Editions Elsevier, c2000-
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MeSH Terms:
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Hypophosphatemia*/drug therapy
Hypophosphatemia*/etiology
Neoplasms, Connective Tissue*/complications
Neoplasms, Connective Tissue*/diagnosis
Neoplasms, Connective Tissue*/drug therapy
Osteomalacia*/diagnosis
Osteomalacia*/drug therapy
Osteomalacia*/etiology
Antibodies, Monoclonal/therapeutic use ; Antibodies, Monoclonal, Humanized ; Fibroblast Growth Factors ; Humans ; Paraneoplastic Syndromes
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Contributed Indexing:
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Keywords: Burosumab; Hypophosphatemia; Metabolic bone disease; Osteomalacia; Tumor-induced osteomalacia
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Substance Nomenclature:
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0 (Antibodies, Monoclonal)
0 (Antibodies, Monoclonal, Humanized)
62031-54-3 (Fibroblast Growth Factors)
G9WJT6RD29 (burosumab)
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SCR Disease Name:
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Oncogenic osteomalacia
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Entry Date(s):
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Date Created: 20190806 Date Completed: 20210625 Latest Revision: 20210625
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Update Code:
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20240105
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DOI:
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10.1016/j.jbspin.2019.07.012
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PMID:
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31382017
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Tumor-induced osteomalacia is a rare cause of acquired hypophosphatemia due to the paraneoplastic overproduction of fibroblast growth factor-23. Unlike many causes of osteomalacia, tumor-induced osteomalacia is curable by resection of the offending tumor. If a patient has a tumor that is unidentifiable, unresectable, or makes the decision to forgo surgery, medical treatment is recommended. Burosumab (KRN23) is a fully human monoclonal antibody against fibroblast growth factor-23 that was recently approved for the treatment of X-linked hypophosphatemia. We present a case of tumor-induced osteomalacia due to two somatostatin receptor avid meningiomas. The patient initially was wheelchair bound due to symptoms of diffuse bone and muscle pain with recurrent traumatic and nontraumatic fractures. Serum phosphate was 1.8mg/dL (reference range: 2.4-5.0mg/dL) with no other laboratory or historical cause. Workup revealed two widely separated intracranial meningiomas with typical magnetic resonance imaging characteristics. The duplicity of tumors precluded safe surgery and the potential delay in, or lack of, efficacy using radiosurgery prompted the treatment team to opt for medical treatment. Burosumab was initiated resulting in improvement in pain symptoms and mobility. Serum phosphate normalized. Trials are ongoing to assess the utility of burosumab in the treatment of tumor-induced osteomalacia.
(Copyright © 2019 Société française de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.)
