Fibroblast growth factor 23-related osteomalacia caused by the prolonged administration of saccharated ferric oxide

Intern Med. 2012;51(17):2375-8. doi: 10.2169/internalmedicine.51.7450. Epub 2012 Sep 1.

Abstract

A 44-year-old woman with iron deficiency anemia was on a continuous course of intravenous saccharated ferric oxide (SFO). She came to our hospital because of right hip joint pain. She was found to have hypophosphatemia caused by impaired phosphorus resorption and her fibroblast growth factor 23 (FGF-23) levels were elevated. Therefore, she was diagnosed with FGF-23-related osteomalacia due to SFO administration. Discontinuation of the SFO treatment rapidly improved the impaired phosphorus resorption and also normalized the blood levels of phosphorus and FGF-23. During the treatment with SFO, it is important to regularly measure the blood levels of phosphorus in order to prevent the occurrence of osteomalacia.

Publication types

  • Case Reports

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Anemia, Iron-Deficiency / blood
  • Anemia, Iron-Deficiency / drug therapy*
  • Dose-Response Relationship, Drug
  • Female
  • Ferric Compounds / adverse effects*
  • Ferric Compounds / therapeutic use*
  • Ferric Oxide, Saccharated
  • Fibroblast Growth Factor-23
  • Fibroblast Growth Factors / blood*
  • Glucaric Acid / adverse effects*
  • Glucaric Acid / therapeutic use*
  • Hematinics / adverse effects*
  • Hematinics / therapeutic use*
  • Humans
  • Osteomalacia / chemically induced*
  • Osteomalacia / diagnosis
  • Osteomalacia / metabolism
  • Phosphorus / blood
  • Time Factors
  • Treatment Outcome
  • Withholding Treatment

Substances

  • FGF23 protein, human
  • Ferric Compounds
  • Hematinics
  • Phosphorus
  • Fibroblast Growth Factors
  • Fibroblast Growth Factor-23
  • Ferric Oxide, Saccharated
  • Glucaric Acid