Chronische botpijn door verhoogde FGF23-productie?

Translated title of the contribution: Chronic bone pain due to raised FGF23 production? the importance of determining phosphate levels

Research output: Contribution to journalArticleAcademicpeer-review


Hypophosphatemia is an important finding in the evaluation of patients with chronic bone pain. Fibroblast-growth factor 23 (FGF23) plays a role in the differential diagnosis of hypophosphatemia. A 34-year-old man had progressive pain in both shoulders and hips due to hypophosphatemic osteomalacia. He had elevated FGF23 levels, induced by a FGF23- producing tumour in the right acetabulum. Thus, he had tumour-induced hypophosphatemic osteomalacia. A 50-year-old man had had bowed legs and joint pains since his youth due to osteomalacia. Several family members also had osteomalacia. His phosphate concentration was low. Genetic testing revealed a mutation on the PHEX gene which results in high FGF23 levels. Thus, he had X-linked hereditary hypophosphatemic osteomalacia. In patients with bone pain, the measurement of a phosphate concentration is important. In renal phosphate loss, the measurement of FGF23 is an important next step if parathormone concentrations are low or normal.

Original languageDutch
Article numberA5908
JournalNederlands Tijdschrift voor Geneeskunde
Issue number28
Publication statusPublished - 14 Oct 2013

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