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OSTEOPOROSIS ASSOCIATED WITH LOW SERUM PHOSPHORUS AND RENAL GLYCOSURIA

OSTEOPOROSIS ASSOCIATED WITH LOW SERUM PHOSPHORUS AND RENAL GLYCOSURIA Abstract WE ARE presenting the history and investigations concerning a patient with progressive decalcification, a low serum phosphorus content and renal glycosuria. The findings suggest that a physiologic defect of the renal tubules is the primary cause for certain osteoporotic conditions of obscure origin. REPORT OF A CASE D. L., a man aged 39 years at death, was born at St. Davids, Pembrokeshire, in 1906, the seventh child of a family of nine, the other members being four brothers and four sisters.As a child he was considered to be healthy and strong. His father died in 1914 of a gastric ulcer, and his mother died (after World War I) of meningitis. Seven of the family are dead, six of tuberculosis and the seventh from an accident. The youngest brother is well.When aged 22, after a severe infection of the throat stiffness developed in his back and muscles, which passed References 1. Smith, H. W.; Goldring, W., and Chasis, H.: Measurement of Tubular Excretory Mass, Effective Blood Flow and Filtration Rate in Normal Human Kidney , J. Clin. Investigation 17:263, 1938.Crossref 2. Albright, F.; Consolazio, W. V.; Coombs, F. S.; Sulkowitch, H. W., and Talbott, J. H.: Metabolic Studies and Therapy in Case of Nephrocalcinosis with Rickets and Dwarfism , Bull. Johns Hopkins Hosp. 66:7, 1940. 3. Fanconi, G.: Nondiabetic Glycosuria and Hyperglycemia in Older Children , Jahrb. f. Kinderh. 133:257, 1931. 4. Snapper, I.: Medical Clinics on Bone Diseases: Text and Atlas , New York, Interscience Publishers, Inc., 1943. 5. Robison, R.: The Significance of Phosphoric Esters in Metabolism , New York, New York University Press, 1932. 6. Kay, H. D.: Phosphatase in Growth and Disease of Bone , Physiol. Rev. 12:384, 1932. 7. Albright, F.; Butler, A. M.; and Bloomberg, E.: Rickets Resistant to Vitamin D Therapy , Am. J. Dis. Child. 54:529 ( (Sept.) ) 1937. 8. Bakwin, H.; Bodansky, O., and Schorr, R.: Refractory Rickets , Am. J. Dis. Child. 59:560 ( (March) ) 1940. 9. Barclay, J. A.; Cooke, W. T.; Kenney, R. A., and Nutt, M. E.: Phosphate Excretion in Man and Dog, read before the Physiological Society, 1946. 10. Smith, H.: Physiology of Kidneys , ed. 2, New York, Oxford University Press, 1943. 11. Pitts, R. F., and Alexander, R.: Renal Reabsorptive Mechanism for Inorganic Phospate in Normal and Acidotic Dogs , Am. J. Physiol. 142:648, 1944. 12. Footnote 8. 13. McFarlane, D.: Experimental Phosphate Nephritis in Rat , J. Path. & Bact. 52:17, 1941. 14. McLeod, J. J. R.: Carbohydrate Metabolism and Insulin , London, Longmans, Green & Company, Ltd., 1926. 15. Reiser, R.: Phosphorus Changes During Absorption of Oil and Glucose , J. Biol. Chem. 135:303, 1940. 16. Hanes, F. M., and Reiser, R.: Relation of Phosphorus to Fat and Glucose Metabolism in Sprue , Am. J. M. Sc. 200:661, 1940. 17. Kaplan, N. O., and Greenberg, D. M.: Action of Insulin on Phosphate Cycle , J. Biol. Chem. 156:553, 1944. 18. Milkman, L. A.: Pseudofractures (Hunger Osteopathy, Late Rickets, Osteomalacia): Report of Case , Am. J. Roentgenol. 24:29, 1930 19. Multiple Spontaneous Idiopathic Symmetrical Fractures . Milkman Am. J. Roentgenol. 32:622, 1934. 20. Michaëlis, L.: Systemic Disease: Case , Fortschr. a. d. Geb. d. Röntgenstrahlen 45:187, 1932. 21. Leedham-Green, J. C., and Golding, F. C.: Osteoporosis Melolytica ("Multiple Spontaneous Idiopathic Symmetrical Fractures") , Brit. J. Surg. 25: 77, 1937. 22. Edeiken, L., and Schneeberg, N. G.: Multiple Spontaneous Idiopathic Symmetrical Fractures: Milkman's Syndrome , J. A. M. A. 122:865 ( (July 24) ) 1943. 23. Camp, J. D., and McCullough, J. A. I.: Pseudofractures in Diseases Affecting the Skeletal System , Radiology 36:651, 1941. 24. Garcin, R.; Legrand, G., and Bernard, P.: Milkman Syndrome of Unknown Etiology: Clinical Cure and Roentgen Improvement Under Influence of Vitamin and Calcium Therapy , Bull. et mém. Soc. méd. d. hôp. de Paris 53:1166, 1937. 25. Leriche, R., and Jung, A.: Spontaneous Nontraumatic Osseous Fissures of Undetermined Origin: Case , Lyon chir. 35:47, 1938. 26. Guillain, G.; Lereboullet, J., and Auzépy, P.: Milkman Syndrome (Multiple Symmetrical Striae of Resorption): Nosographic Considerations; Case , Bull. et mém. Soc. méd. d. hôp. de Paris 53:879, 1937. 27. Ravault, P. P.; Girard, M., and Didierlaurent: Symmetrical Spontaneous Fissuration (Milkman Syndrome) , Lyon méd. 162:189 and 217, 1938. 28. Debray, M.; Andre, T., and Gireaux: A Case of Multiple Spontaneous Fractures Difficult to Classify: Nosologic Discussion , Bull. et mém. Soc. méd. d. hôp. de Paris 49:1038, 1933. 29. Debray, M.: Chronic Painful Osteopathy with Multiple Symmetrical Pseudofractures: Case , Bull. et mém. Soc. méd. d. hôp. de Paris 56:573, 1940. 30. Lombard, P., and Tiller, H.: Spontaneous Fissuratin of the Skeleton , Mém. Acad. de chir. 64:336, 1938. 31. Fanconi, G.: Nephrotic-Glycosuric Dwarfism with Hypo-nephrotisch-glykosurische Zwergwuchs mit hypophospha-phasphatemic Rickets , Jahrb. f. Kinderh. 147:299, 1936 32. footnote 3. 33. McCune, D. J.; Mason, H. H., and Clarke, H. T.: Intractable Hypophosphatemic Rickets with Renal Glycosuria and Acidosis (Fanconi Syndrome): Report of Case in Which Increased Urinary Organic Acids Were Detected and Identified with Review of Literature , Am. J. Dis. Child. 65:81 ( (Jan.) ) 1943.Crossref 34. Hunter, D.: Studies in Calcium and Phosphorus Metabolism in Generalized Diseases of Bones , Proc. Roy. Soc. Med. 28:1619, 1935. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

OSTEOPOROSIS ASSOCIATED WITH LOW SERUM PHOSPHORUS AND RENAL GLYCOSURIA

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Publisher
American Medical Association
Copyright
Copyright © 1947 American Medical Association. All Rights Reserved.
ISSN
0730-188X
DOI
10.1001/archinte.1947.00220140003001
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Abstract

Abstract WE ARE presenting the history and investigations concerning a patient with progressive decalcification, a low serum phosphorus content and renal glycosuria. The findings suggest that a physiologic defect of the renal tubules is the primary cause for certain osteoporotic conditions of obscure origin. REPORT OF A CASE D. L., a man aged 39 years at death, was born at St. Davids, Pembrokeshire, in 1906, the seventh child of a family of nine, the other members being four brothers and four sisters.As a child he was considered to be healthy and strong. His father died in 1914 of a gastric ulcer, and his mother died (after World War I) of meningitis. Seven of the family are dead, six of tuberculosis and the seventh from an accident. The youngest brother is well.When aged 22, after a severe infection of the throat stiffness developed in his back and muscles, which passed References 1. Smith, H. W.; Goldring, W., and Chasis, H.: Measurement of Tubular Excretory Mass, Effective Blood Flow and Filtration Rate in Normal Human Kidney , J. Clin. Investigation 17:263, 1938.Crossref 2. Albright, F.; Consolazio, W. V.; Coombs, F. S.; Sulkowitch, H. W., and Talbott, J. H.: Metabolic Studies and Therapy in Case of Nephrocalcinosis with Rickets and Dwarfism , Bull. Johns Hopkins Hosp. 66:7, 1940. 3. Fanconi, G.: Nondiabetic Glycosuria and Hyperglycemia in Older Children , Jahrb. f. Kinderh. 133:257, 1931. 4. Snapper, I.: Medical Clinics on Bone Diseases: Text and Atlas , New York, Interscience Publishers, Inc., 1943. 5. Robison, R.: The Significance of Phosphoric Esters in Metabolism , New York, New York University Press, 1932. 6. Kay, H. D.: Phosphatase in Growth and Disease of Bone , Physiol. Rev. 12:384, 1932. 7. Albright, F.; Butler, A. M.; and Bloomberg, E.: Rickets Resistant to Vitamin D Therapy , Am. J. Dis. Child. 54:529 ( (Sept.) ) 1937. 8. Bakwin, H.; Bodansky, O., and Schorr, R.: Refractory Rickets , Am. J. Dis. Child. 59:560 ( (March) ) 1940. 9. Barclay, J. A.; Cooke, W. T.; Kenney, R. A., and Nutt, M. E.: Phosphate Excretion in Man and Dog, read before the Physiological Society, 1946. 10. Smith, H.: Physiology of Kidneys , ed. 2, New York, Oxford University Press, 1943. 11. Pitts, R. F., and Alexander, R.: Renal Reabsorptive Mechanism for Inorganic Phospate in Normal and Acidotic Dogs , Am. J. Physiol. 142:648, 1944. 12. Footnote 8. 13. McFarlane, D.: Experimental Phosphate Nephritis in Rat , J. Path. & Bact. 52:17, 1941. 14. McLeod, J. J. R.: Carbohydrate Metabolism and Insulin , London, Longmans, Green & Company, Ltd., 1926. 15. Reiser, R.: Phosphorus Changes During Absorption of Oil and Glucose , J. Biol. Chem. 135:303, 1940. 16. Hanes, F. M., and Reiser, R.: Relation of Phosphorus to Fat and Glucose Metabolism in Sprue , Am. J. M. Sc. 200:661, 1940. 17. Kaplan, N. O., and Greenberg, D. M.: Action of Insulin on Phosphate Cycle , J. Biol. Chem. 156:553, 1944. 18. Milkman, L. A.: Pseudofractures (Hunger Osteopathy, Late Rickets, Osteomalacia): Report of Case , Am. J. Roentgenol. 24:29, 1930 19. Multiple Spontaneous Idiopathic Symmetrical Fractures . Milkman Am. J. Roentgenol. 32:622, 1934. 20. Michaëlis, L.: Systemic Disease: Case , Fortschr. a. d. Geb. d. Röntgenstrahlen 45:187, 1932. 21. Leedham-Green, J. C., and Golding, F. C.: Osteoporosis Melolytica ("Multiple Spontaneous Idiopathic Symmetrical Fractures") , Brit. J. Surg. 25: 77, 1937. 22. Edeiken, L., and Schneeberg, N. G.: Multiple Spontaneous Idiopathic Symmetrical Fractures: Milkman's Syndrome , J. A. M. A. 122:865 ( (July 24) ) 1943. 23. Camp, J. D., and McCullough, J. A. I.: Pseudofractures in Diseases Affecting the Skeletal System , Radiology 36:651, 1941. 24. Garcin, R.; Legrand, G., and Bernard, P.: Milkman Syndrome of Unknown Etiology: Clinical Cure and Roentgen Improvement Under Influence of Vitamin and Calcium Therapy , Bull. et mém. Soc. méd. d. hôp. de Paris 53:1166, 1937. 25. Leriche, R., and Jung, A.: Spontaneous Nontraumatic Osseous Fissures of Undetermined Origin: Case , Lyon chir. 35:47, 1938. 26. Guillain, G.; Lereboullet, J., and Auzépy, P.: Milkman Syndrome (Multiple Symmetrical Striae of Resorption): Nosographic Considerations; Case , Bull. et mém. Soc. méd. d. hôp. de Paris 53:879, 1937. 27. Ravault, P. P.; Girard, M., and Didierlaurent: Symmetrical Spontaneous Fissuration (Milkman Syndrome) , Lyon méd. 162:189 and 217, 1938. 28. Debray, M.; Andre, T., and Gireaux: A Case of Multiple Spontaneous Fractures Difficult to Classify: Nosologic Discussion , Bull. et mém. Soc. méd. d. hôp. de Paris 49:1038, 1933. 29. Debray, M.: Chronic Painful Osteopathy with Multiple Symmetrical Pseudofractures: Case , Bull. et mém. Soc. méd. d. hôp. de Paris 56:573, 1940. 30. Lombard, P., and Tiller, H.: Spontaneous Fissuratin of the Skeleton , Mém. Acad. de chir. 64:336, 1938. 31. Fanconi, G.: Nephrotic-Glycosuric Dwarfism with Hypo-nephrotisch-glykosurische Zwergwuchs mit hypophospha-phasphatemic Rickets , Jahrb. f. Kinderh. 147:299, 1936 32. footnote 3. 33. McCune, D. J.; Mason, H. H., and Clarke, H. T.: Intractable Hypophosphatemic Rickets with Renal Glycosuria and Acidosis (Fanconi Syndrome): Report of Case in Which Increased Urinary Organic Acids Were Detected and Identified with Review of Literature , Am. J. Dis. Child. 65:81 ( (Jan.) ) 1943.Crossref 34. Hunter, D.: Studies in Calcium and Phosphorus Metabolism in Generalized Diseases of Bones , Proc. Roy. Soc. Med. 28:1619, 1935.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Aug 1, 1947

References