{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T22:12:50Z","timestamp":1783548770427,"version":"3.55.0"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T00:00:00Z","timestamp":1705017600000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec><jats:title>Key Clinical Message<\/jats:title><jats:p>This case report describes the clinical course of a juvenile female with FGF23\u2010related hypophosphatemic rickets preceding the onset of SLE. Our study demonstrates the possibility of hypophosphatemic rickets as an early symptom of SLE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p>Fibroblast growth factor 23 (FGF23)\u2010related hypophosphatemic rickets is observed in both genetic and acquired disorders. Various reports describe FGF23\u2010related hypophosphatemia with systemic lupus erythematosus (SLE), although FGF23\u2010related hypophosphatemia preceding the onset of SLE has never been described. Here, we report the case of a 9\u2010year\u2010old female with FGF23\u2010related hypophosphatemic rickets preceding the onset of SLE. The patient presented to us with arthralgia in the lower extremities and abnormality of gait lasting for 8\u2009months. She was diagnosed with FGF23 hypophosphatemic rickets due to the presence of hypophosphatemic rickets symptoms and high serum levels of FGF23. Additional examination excluded hereditary diseases and tumor\u2010induced osteomalacia. Three months after diagnosis of FGF23\u2010related hypophosphatemic rickets, she developed nephritis and was diagnosed with SLE. She was treated with prednisolone, hemodialysis, and disease\u2010modifying drugs, as well as oral sodium phosphate to improve hypophosphatemia. Serum anti\u2010double\u2010stranded DNA antibody (dsDNAab) and plasma tumor necrosis factor\u2010\u03b1 (TNF\u2010\u03b1) were elevated at FGF23\u2010related hypophosphatemic rickets diagnosis. During the clinical course, serum FGF23 correlated with dsDNAab and TNF\u2010\u03b1 serum levels, which are involved in SLE disease activity. In this case, FGF23\u2010related hypophosphatemic rickets without hereditary diseases or tumor\u2010induced osteomalacia occurred before the appearance of juvenile SLE symptoms, and serum FGF23 represented disease activity in SLE.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccr3.8420","type":"journal-article","created":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T09:25:00Z","timestamp":1705051500000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["FGF23\u2010related hypophosphatemic rickets preceding the onset of systemic lupus erythematosus: A juvenile case"],"prefix":"10.1002","volume":"12","author":[{"given":"Yoko","family":"tabei","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine Gunma University  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5671-5393","authenticated-orcid":false,"given":"Yoshiaki","family":"Ohtsu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine Gunma University  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaharu","family":"Shimada","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine Gunma University  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine Gunma University  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emi","family":"Hamajima","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine Gunma University  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshimitsu","family":"Osawa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine Gunma University  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takumi","family":"Takizawa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine Gunma University  Maebashi 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Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.8420","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T03:56:06Z","timestamp":1706846166000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.8420"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1002\/ccr3.8420"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.8420","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"2023-09-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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