Department of Medicine, School of Medicine and Health Sciences, Sana'a University, PO Box 12268, Sana'a, Yemen.
Department of Orthopedic Surgery, University of Science and Technology Hospital, PO Box 13061, Sana'a, Yemen.
J Med Case Rep. 2021 Feb 7;15(1):48. doi: 10.1186/s13256-020-02654-9.
Hypophosphatemic rickets is associated with delayed walking, bone deformities, growth failure and physical dysfunction that can limit daily activities. Treatment consists of phosphate salts and calcitriol. We report a case that received denosumab with marked improvement in her condition.
A 24-year-old Yemeni female with hypophosphatemic rickets presented to an endocrinologist with severe weakness and severe pain in the extremities, she had been bedridden for the last 4 years. Bone density showed severe osteoporosis (T score of hip was - 5.0 and Z score of hip was - 5.0, T score of the spine was - 6.0 and Z score of the spine was - 6.1) so the patient was started on denosumab in addition to calcitriol and after 7months she was feeling stronger and felt she could stand assisted and was walking with assistance within 9 months and after 1.5 years of treatment she was walking unassisted.
Denosumab is an effective treatment for osteoporosis, we used it in our patient in addition to calcitriol because she had severe osteoporosis due to long standing hypophosphatemic rickets that had not been treated properly, the patient improved markedly and regained the ability to walk again after being bedridden for 4 years. It may be a drug to consider in such cases although further studies need to be done to confirm this.
低磷血症性佝偻病与行走延迟、骨骼畸形、生长发育迟缓以及身体功能障碍有关，这些都会限制日常活动。治疗方法包括磷酸盐盐和骨化三醇。我们报告了一例使用地舒单抗治疗后病情明显改善的病例。
一名 24 岁的也门女性患有低磷血症性佝偻病，因严重的四肢无力和疼痛就诊于内分泌科，她已经卧床 4 年了。骨密度显示严重骨质疏松症（髋部 T 评分-5.0，髋部 Z 评分-5.0，脊柱 T 评分-6.0，脊柱 Z 评分-6.1），因此患者开始接受地舒单抗治疗，同时还服用骨化三醇。7 个月后，她感觉更强壮，感觉自己可以在辅助下站立，9 个月后可以在辅助下行走，1.5 年治疗后可以独立行走。
地舒单抗是一种有效的骨质疏松症治疗药物，我们在该患者中除了使用骨化三醇外还使用了它，因为她患有严重的骨质疏松症，这是由于长期未得到适当治疗的低磷血症性佝偻病引起的。患者明显改善，在卧床 4 年后再次恢复行走能力。虽然需要进一步的研究来证实这一点，但它可能是这类病例中值得考虑的一种药物。
