Huaux J P, Malghem J, Maldague B, Devogelaer J P, Esselinckx W, Withofs H, Nagant de Deuxchaisnes C
Arthritis Rheum. 1986 Jul;29(7):918-25. doi: 10.1002/art.1780290717.
We report 2 patients with reflex sympathetic dystrophy syndrome (RSDS) associated with renal tubular osteomalacia. In both patients, RSDS was the presenting manifestation. Treatment of the underlying condition with calcitriol resulted in healing in both patients. These cases prompted us to undertake a retrospective study of 24 consecutive patients with osteomalacia (6 of renal tubular origin, 18 related to vitamin D deficiency), and of 259 consecutive patients with RSDS. Among those with osteomalacia, radiologic lesions strongly suggestive of RSDS were found in 5 patients (21%), 4 of whom had renal tubular defects, and only 1 had vitamin D deficiency. In the group with RSDS, 1 patient (0.4%) was found to have osteomalacia of renal tubular origin. Thus, radiologic findings suggestive of RSDS are frequent in patients with osteomalacia, especially that of renal tubular origin. On rare occasions, the full-blown clinical picture of RSDS may obscure the diagnosis of osteomalacia.
我们报告了2例与肾小管性骨软化症相关的反射性交感神经营养不良综合征（RSDS）患者。在这2例患者中，RSDS均为首发表现。使用骨化三醇治疗潜在疾病后，2例患者均痊愈。这些病例促使我们对24例连续的骨软化症患者（6例为肾小管源性，18例与维生素D缺乏相关）以及259例连续的RSDS患者进行了回顾性研究。在骨软化症患者中，5例（21%）发现有强烈提示RSDS的放射学病变，其中4例有肾小管缺陷，只有1例有维生素D缺乏。在RSDS组中，发现1例（0.4%）患者有肾小管源性骨软化症。因此，提示RSDS的放射学表现在骨软化症患者中很常见，尤其是肾小管源性骨软化症。在极少数情况下，RSDS的典型临床表现可能会掩盖骨软化症的诊断。
