Grand Rounds Section Editor: David S. Cooper,
MD, Contributing Editor, JAMA.
Author Affiliation: Department of Medicine,
Johns Hopkins University School of Medicine, and Department of Endocrinology,
Johns Hopkins Bayview Medical Center, Baltimore, Md.
Tumor-induced osteomalacia (TIO) is a rare paraneoplastic form of renal
phosphate wasting that results in severe hypophosphatemia, a defect in vitamin
D metabolism, and osteomalacia. This debilitating disorder is illustrated
by the clinical presentation of a 55-year-old woman with progressive fatigue,
weakness, and muscle and bone pain with fractures. After a protracted clinical
course and extensive laboratory evaluation, tumor-induced osteomalacia was
identified as the basis of her clinical presentation. In this article, the
distinctive clinical characteristics of this syndrome, the advances in diagnosis
of TIO, and new insights into the pathophysiology of this disorder are discussed.
Jan de Beur SM. Tumor-Induced Osteomalacia. JAMA. 2005;294(10):1260-1267. doi:10.1001/jama.294.10.1260