{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:40:09Z","timestamp":1756312809565,"version":"3.44.0"},"reference-count":17,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,11,22]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:p>Patients with osteomalacia have a low bone mineral density (BMD) and are often misdiagnosed as osteoporosis. A marked increase in BMD is noticed following successful treatment of osteomalacia. The biochemical hallmark of tumour-induced osteomalacia (TIO) is hypophosphatemia. Patients with TIO often have severe hypophosphatemic osteomalacia and dual-energy X-ray absorptiometry may demonstrate low BMD. Surgical removal of the phosphatonin-secreting lesion restores serum phosphate, corrects osteomalacia and is associated with a dramatic increase in BMD. We report two patients with TIO and low BMD, who were treated with oral phosphate and calcitriol supplementation. The percentage increase in BMD at 33 months was as high as 94.3% in areas with the lowest BMD at baseline. The BMD at 33 months was higher than the +2SD of the population-specific reference ranges, a finding not reported in surgically treated patients with TIO. An intermittent rise in parathyroid hormone following oral phosphate supplementation might have resulted in such findings.<\/jats:p>","DOI":"10.1136\/bcr-2023-255355","type":"journal-article","created":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T12:51:37Z","timestamp":1701867097000},"page":"e255355","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Marked increase in bone mineral density with oral phosphate and calcitriol in tumour-induced osteomalacia"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3316-4525","authenticated-orcid":false,"given":"Partha Pratim","family":"Chakraborty","sequence":"first","affiliation":[{"name":"Endocrinology and Metabolism, Medical College and Hospital Kolkata, Kolkata, West Bengal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rana","family":"Bhattacharjee","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism, Medical College and Hospital Kolkata, Kolkata, West Bengal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajitesh","family":"Roy","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Subhankar","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism, IPGME&R\/SSKM Hospital, Kolkata, West Bengal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,12,6]]},"reference":[{"key":"2025082709225099000_16.12.e255355.1","first-page":"1","article-title":"Osteoporosis prevention, diagnosis, and therapy","volume":"17","year":"2000","journal-title":"NIH Consens Statement"},{"key":"2025082709225099000_16.12.e255355.2","first-page":"180","article-title":"Bone densitometry in patients with osteomalacia: is it valuable","volume":"10","author":"Saghafi","year":"2013","journal-title":"Clin Cases Miner Bone Metab"},{"doi-asserted-by":"publisher","key":"2025082709225099000_16.12.e255355.3","DOI":"10.1016\/j.ecl.2012.05.005"},{"key":"2025082709225099000_16.12.e255355.4","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1002\/biof.1186","article-title":"Bone mineralization is regulated by signaling cross talk between molecular factors of local and systemic origin: the role of fibroblast growth factor 23","volume":"40","author":"Sapir-Koren","year":"2014","journal-title":"Biofactors"},{"key":"2025082709225099000_16.12.e255355.5","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1007\/s00198-020-05369-1","article-title":"Long-term bone mineral density changes after surgical cure of patients with tumor-induced osteomalacia","volume":"31","author":"Colangelo","year":"2020","journal-title":"Osteoporos Int"},{"doi-asserted-by":"publisher","key":"2025082709225099000_16.12.e255355.6","DOI":"10.4158\/EP.13.5.458"},{"key":"2025082709225099000_16.12.e255355.7","doi-asserted-by":"crossref","DOI":"10.1016\/j.bonr.2020.100276","article-title":"Lessons learnt from delayed diagnosis of FGF-23-producing tumour-induced osteomalacia and post-operative hungry bone syndrome","volume":"12","author":"Kumar","year":"2020","journal-title":"Bone Rep"},{"key":"2025082709225099000_16.12.e255355.8","doi-asserted-by":"crossref","first-page":"7925","DOI":"10.2147\/IJGM.S332534","article-title":"Changes in bone mineral density following conventional oral phosphonate treatment of hypophosphatemic osteomalacia: a non-randomized controlled study","volume":"14","author":"Guo","year":"2021","journal-title":"Int J Gen Med"},{"unstructured":"Hayashi N , Imanishi Y , Ohara M , et al . Increased bone mineral density and improved metabolic bone markers in patients with hypophosphatemic Rickets\/Osteomalacia treated with the calcimimetic. 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