{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T05:20:36Z","timestamp":1770960036443,"version":"3.50.1"},"reference-count":9,"publisher":"The Endocrine Society","issue":"1","license":[{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"vor","delay-in-days":34,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Hypophosphatasia is a rare metabolic bone disorder that is often misdiagnosed. We present the case of a middle-aged woman initially misdiagnosed with rickets and later as osteogenesis imperfecta and treated with zoledronate, after which she developed atypical femoral fractures. After switching to teriparatide therapy, her bone mineral density improved significantly. This case underscores that persistently low alkaline phosphatase with fragility or atypical fractures should prompt evaluation for hypophosphatasia and that antiresorptives (eg, bisphosphonates) may precipitate atypical fractures in this condition and should be avoided. Disease-specific therapy is enzyme replacement with asfotase alfa; anabolic therapy may improve bone mineral density in selected adults when asfotase alfa is unavailable.<\/jats:p>","DOI":"10.1210\/jcemcr\/luaf291","type":"journal-article","created":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T12:53:43Z","timestamp":1762692823000},"source":"Crossref","is-referenced-by-count":1,"title":["Atypical Fracture From Bisphosphonate Use in Hypophosphatasia With Improved Bone Response to Teriparatide Therapy"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3088-3778","authenticated-orcid":false,"given":"Edwin","family":"Mora Garzon","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine and Epidemiology, S.E.S. Hospital Universitario de Caldas, Universidad de Caldas , Manizales 170003 ,","place":["Colombia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8213-8937","authenticated-orcid":false,"given":"Daniel","family":"Betancourt Zuluaga","sequence":"additional","affiliation":[{"name":"Research Group on Geriatrics and Gerontology, Faculty of Health Sciences, Universidad de Caldas , Manizales 170003 ,","place":["Colombia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5178-7822","authenticated-orcid":false,"given":"Juan David","family":"Salazar Ospina","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Universidad de Caldas , Manizales 170003 ,","place":["Colombia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5094-9391","authenticated-orcid":false,"given":"Sebasti\u00e1n","family":"L\u00f3pez Vel\u00e1squez","sequence":"additional","affiliation":[{"name":"Medical Research Group, Faculty of Health Sciences, Universidad de Manizales 170003 , Manizales ,","place":["Colombia"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"issue":"2","key":"2026010603475545100_luaf291-B1","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1007\/s12020-024-04054-1","article-title":"Diagnosis, treatment, and follow-up of patients with hypophosphatasia","volume":"87","author":"C\u00e1rdenas-Aguilera","year":"2025","journal-title":"Endocrine"},{"issue":"8","key":"2026010603475545100_luaf291-B2","doi-asserted-by":"crossref","first-page":"941","DOI":"10.4158\/EP15890.OR","article-title":"Adult hypophosphatasia treated with teriparatide: report of 2 patients and review of the literature","volume":"22","author":"Camacho","year":"2016","journal-title":"Endocr 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