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Abstracts |

Refractory Osteomalacia: Factors in Pathogenesis and Treatment.

B. Frame, M.D., F.A.C.P.; R. W. Smith Jr., M.D., F.A.C.P.; J. L. Fleming, M.D.; and G. Manson, M.D.
Ann Intern Med. 1962;56(4):674-675. doi:10.7326/0003-4819-56-4-674_2
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Varieties of rickets and osteomalacia that are resistant to treatment with large doses of vitamin D have recently received increasing medical attention. The etiologic role for primary vitamin D resistance versus a primary renal tubular defect for phosphorus in the condition has not as yet been fully defined.

The authors have under observation three cases of congenital and two cases of acquired refractory rickets and osteomalacia. Metabolic features include persistent fasting hypophosphatemia, increased renal clearance of phosphorus, decreased intestinal absorption of calcium, and failure to respond to conventional doses of vitamin D. The more common forms of rickets and osteomalacia




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