Autosomal dominant hypophosphatemic rickets (ADHR) is a rare hereditary disease in which excessive loss of phosphate in the urine leads to poorly formed bones (rickets), bone pain, and tooth abscesses. ADHR is caused by a mutation in the fibroblast growth factor 23 (FGF23). ADHR affects men and women equally; symptoms may become apparent at any point from childhood through early adulthood. Blood tests reveal low levels of phosphate (hypophosphatemia) and inappropriately normal levels of vitamin D.[1] Occasionally, hypophosphatemia may improve over time as urine losses of phosphate partially correct.[1]

ADHR may be lumped in with X-linked hypophosphatemia under general terms such as hypophosphatemic rickets. Hypophosphatemic rickets are associated with at least nine other genetic mutations.[2] Clinical management of hypophosphatemic rickets may differ depending on the specific mutations associated with an individual case, but treatments are aimed at raising phosphate levels to promote normal bone formation.[3] In a 2019 randomised, clinical trial the rickets in children with X-linked hypophosphataemia treated with a human monoclonal antibody against FGF23 called burosumab improved significantly compared to conventional therapy.[4]

References

  1. ^ a b "Entry - #193100 - HYPOPHOSPHATEMIC RICKETS, AUTOSOMAL DOMINANT; ADHR - OMIM". www.omim.org. Retrieved 2025-01-14.
  2. ^ Online Mendelian Inheritance in Man (OMIM): 193100
  3. ^ "Hypophosphatemic rickets". Genetic and Rare Diseases Information Center. National Institutes of Health. Archived from the original on 12 June 2012. Retrieved 10 October 2012.
  4. ^ Imel EA, Glorieux FH, Whyte MP, Munns CF, Ward LM, Nilsson O, et al. (June 2019). "Burosumab versus conventional therapy in children with X-linked hypophosphataemia: a randomised, active-controlled, open-label, phase 3 trial". Lancet. 393 (10189): 2416–2427. doi:10.1016/S0140-6736(19)30654-3. PMC 7179969. PMID 31104833.

Further reading


No tags for this post.