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Phosphorus Metabolic Disorder

HPP


Presentation

  • In the body, phosphorus is present as a stable inorganic phosphate (Pi), an organic phosphate ester, or a phospholipid.[merckvetmanual.com]
  • Hypophosphatasia: nonlethal disease despite skeletal presentation in utero (17 new cases and literature review). J Bone Miner Res. 2011;26:2389-2398. Whyte MP. Physiological role for alkaline phosphatase explored in hypophosphatasia.[rarediseases.org]
  • Defects in the calcium-sensing receptor gene: Presents as hypocalcaemia, inappropriately normal levels of PTH and raised phosphate levels. This is not true hypoparathyroidism but its presentation mimics it. Can present from birth to adulthood.[patient.info]
  • Infrequently patients might present in the outpatient settings with non-specific symptoms that might be due to abnormalities of divalent cation (magnesium, calcium) or phosphorous metabolism.[ncbi.nlm.nih.gov]
  • According to the results of present study showed that 42% of patients were suffering from nutritional rickets which was the majority among patients.[alliedacademies.org]
Malnutrition
  • Malnutrition due to chronic alcoholism can result in an inadequate intake of phosphorus.[medical-dictionary.thefreedictionary.com]
  • Decreased Intake or Absorption Increased Renal Excretion Shift Genetic Disorders Malnutrition Hyperparathyroidism Elevated serum insulin or glucose levels Autosomal dominant hereditary hypophosphatemic rickets (ADHR) Vitamin D deficiency or resistance[renalandurologynews.com]
  • […] have written informed consent Negative serum pregnancy test if appropriate Expected to be able to comply with protocol procedures and schedule Exclusion Criteria: Unstable angina pectoris Severe congestive heart failure Severe liver dysfunction Severe malnutrition[clinicaltrials.gov]
  • Phosphorus deficiencies (hypophosphatemia) may be seen with malnutrition, malabsorption, acid-base imbalances, increased blood calcium, and with disorders that affect kidney function.[labtestsonline.org]
  • In contrast, hypocalcemia was associated with an increased risk of death in unadjusted and case-mix adjusted models (reference calcium group: 9–9.5 mg/dL); however, controlling for malnutrition-inflammation complex syndrome (MICS) surrogates substantially[mdpi.com]
Veterinarian
  • This publication is a good source for veterinarians and livestock farmers concerned with metabolic diseases in farm animals.[books.google.de]
  • Severe cases require intensive calcium and vitamin supplementation as well as an increase in high-intensity UVB rays under an exotics veterinarian's care.[thespruce.com]
Plethora
  • Professor, Department of Farm Animal Health, Utrecht University Disorders of Phosphorus Metabolism Overview of Disorders of Phosphorus Metabolism Hypophosphatemia Hyperphosphatemia Postparturient Hemoglobinuria Phosphorus (P) is a macromineral with a plethora[merckvetmanual.com]
Fever
  • This text covers the changes in mineral metabolism at parturition; factors predisposing dairy cows to parturient paresis; cause of paresis in milk fever; and downer syndrome in dairy cows.[books.google.de]
Hypertension
  • Specialty Care Sharma, Amita, MD Clinical Interests Genetic disorders affecting the regulation of mineral ion ho Chronic kidney disease Kidney stone disease Glomerular disease Transplantation Hypertension Pediatric Hypertension Nephrology Pediatric Nephrology[massgeneral.org]
  • Traditional risk factors for CVD, such as advanced age, hypertension, and smoking, alone cannot fully explain this high prevalence.[mdpi.com]
Osteoporosis
  • The Johns Hopkins Metabolic Bone and Osteoporosis Center focuses on services designed to prevent, diagnose and treat many kinds of bone diseases, including: Osteoporosis and osteopenia in men and women Fragility and recurrent fractures Vitamin D deficiency[hopkinsmedicine.org]
  • Osteoporosis Osteoporosis is a disease characterized by increasing bone loss which can lead to fractures, height loss and a hump-backed appearance.[washendo.com]
  • Osteoporosis Osteoporosis is a disease characterized by increased bone mineral loss that can lead to fractures, loss of height, and a hump-backed appearance. The problem is very common in older populations.[decorlando.com]
  • An improper balance of phosphorus and calcium may cause osteoporosis. Dietary sources of phosphorus include milk products, egg yolk, legumes, nuts, and whole grains.[britannica.com]
  • Osteoporosis. 3. Bone pains. 4. Bone fractures. 5. Rarely, a marked elevation in blood calcium level can cause confusion, drowsiness and even coma.[onlinemedinfo.com]
Long Bone Deformity
  • Autosomal recessive hypophosphatasia manifesting in utero with long bone deformity but showing spontaneous postnatal improvement. J Clin Endocrinol Metab. 2008;93:3443-3448. Whyte MP, Mumm S, Deal C. Adult hypophosphatasia treated with teriparatide.[rarediseases.org]
Genu Valgum
  • The severity of involvement of particular epiphyses and the nature of the deformity (eg, genu valgum or varum) depends on the relative growth rate, which varies with age (Figure 3).[healio.com]
Kidney Failure
  • Hyperphosphatemia Kidney Failure Drug: calcium acetate Drug: placebo Phase 3 Detailed Description: In patients with impaired kidney function, dietary phosphorus can not be completely excreted, which leads to elevated levels of serum phosphorus.[clinicaltrials.gov]
  • It is most often caused by a decline in the normal excretion of phosphate in urine as a result of kidney failure or impaired function.[medical-dictionary.thefreedictionary.com]
  • In patients with chronic kidney failure (often patients on dialysis), a special form of vitamin D deficiency takes place. In these patients, 1,25 OH vitamin D level is also low, as the kidneys cannot convert 25 OH vitamin D into 1,25 OH vitamin D.[onlinemedinfo.com]
  • Assistance from a dietician is especially useful in patients with chronic kidney failure and hyperphosphatemia, as many foods are high in phosphorus and therefore implementation of a low phosphorus diet is key.[renalandurologynews.com]
  • Calcitriol: a better option than vitamin D in denosumab-treated patients with kidney failure? Expert Opin Biol Ther 2013; 13: 149-151. Jover CA, Bagan JV, Jimenez SY, Poveda RR. Dental management in renal failure: patients on dialysis.[alliedacademies.org]
Paresis
  • This text covers the changes in mineral metabolism at parturition; factors predisposing dairy cows to parturient paresis; cause of paresis in milk fever; and downer syndrome in dairy cows.[books.google.de]

Treatment

  • Their condition resists treatment with most forms of Vitamin D, although a more active form of this vitamin hormone is an important part of their treatment.[xlhnetwork.org]
  • Whyte MP, Greenber CR, Ozone K, Riese R, Moseley S, Melian A, Thompson D, Hofmann C: Asfotase Alfa Treatment Improves Survival For Preinatal And Infantile Hypophosphatasia. Journal of Clinical Endocrinology and metabolism 2016;101: 334-42.[rarediseases.org]
  • Lost bone cannot be replaced, but the treatment team will work with you to prevent further weakening.[washendo.com]
  • Treatment requires increasing the body’s level of vitamin D by making dietary changes and taking supplements.[decorlando.com]
  • Radiation or drugs: Neck or chest irradiation during radiotherapy treatment. Radioactive iodine treatment for hyperthyroidism: a rare side-effect. Chemotherapeutic/cytotoxic agents. Alcohol.[patient.info]

Prognosis

  • Prognosis The prognosis for treating hyperphosphatemia and hypophosphatemia are excellent, though in cases where these problems are due to genetic disease, lifelong hormone treatment may be necessary.[medical-dictionary.thefreedictionary.com]
  • Prognosis The regular monitoring required to ensure appropriate calcium levels means that the prognosis is challenging for many people. This may improve if synthetic PTH becomes widely available.[patient.info]
  • Depending on the severity of the diet, site of fractures (e.g. thoracic (chest) area has potential for extremely grave prognosis), age of animal, and other problems (e.g. parasites, infection, etc.), the animal is ill enough to die at any point if intervention[opossum.org]
  • With serum phosphorus and calcium levels, it is widely accepted that standard levels be set based on the relationship with life prognosis [ 22, 26, 27 ].[mdpi.com]

Etiology

  • Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10coded.com]
  • OSTEITIS DEFORMANS • Early • Intermediate • Late • Etiology  Genetic link  Viral infection  Inflammatory  Vascular disorders Autoimmune connective tissue 72 73.[slideshare.net]
  • If FEPO4 is 5%, renal wasting is present, implicating hyperparathyroidism or alternate etiologies of renal tubular defects.[clinicaladvisor.com]
  • Hypoparathyroidism (HPT) is a disease caused by insufficient secretion of Parathyroid Hormone (PTH) and with unknown etiology.[alliedacademies.org]

Epidemiology

  • "Inherited Metabolic Disorders Overview: Overview, Clinical Features and Differential Diagnosis, Epidemiology and Statistics". 2018-08-09. "Inborn errors of metabolism". MedlinePlus Medical Encyclopedia. Retrieved 27 July 2015.[en.wikipedia.org]
  • Epidemiology This is a rare disorder. Found equally in males and females. Age of onset depends on the aetiology. Aetiology Hypoparathyroidism may be transient, congenital/genetically inherited or acquired.[patient.info]
  • In some studies, risk associations have also been reported between the development and progression of calcification, and epidemiological and biochemical parameters [ 97, 98, 99, 100 ].[mdpi.com]
Sex distribution
Age distribution

Pathophysiology

  • Since publication of the KDIGO CKD–MBD guideline in 2009, our understanding of disease pathophysiology has improved; however, a paucity of high-quality clinical evidence to support specific interventions remains.[nature.com]
  • In terms of pathophysiological/mechanism interactions, an abnormal gut microbioma can play a role in metabolic disorder related obesity. [8] Screening [ edit ] Metabolic disorder screening can be done in newborns via the following methods: [9] Blood test[en.wikipedia.org]
  • Pathophysiology, therapy, and oral implications of renal failure in children and adolescents: an update. Pediatr Dent 2005; 27: 98-106. Assadi F. Hypophosphatemia: an evidence-based problem-solving approach to clinical cases.[alliedacademies.org]

Prevention

  • Vitamin D-Resistant Rickets was the term first used for this disorder because XLH was initially recognized by the ineffectiveness of normal diets to prevent rickets.[xlhnetwork.org]
  • Prevention Phosphorus imbalances caused by hormonal disorders or other genetically determined conditions cannot be prevented.[medical-dictionary.thefreedictionary.com]
  • Prevention of Metabolic Bone Disease in Reptiles Proper husbandry is more than just providing the right diet.[thespruce.com]
  • Prompt identification and treatment of the underlying disorders result in prevention of serious morbidity and mortality.[ncbi.nlm.nih.gov]
  • The Johns Hopkins Metabolic Bone and Osteoporosis Center focuses on services designed to prevent, diagnose and treat many kinds of bone diseases, including: Osteoporosis and osteopenia in men and women Fragility and recurrent fractures Vitamin D deficiency[hopkinsmedicine.org]

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