Tumor induced osteomalacia: Associated with elevated circulating levels of fibroblast growth factor-7 in addition to fibroblast growth factor-23

Shweta Bansal, Khaled Khazim, Rajeev Suri, DeAndra Martin, Sherry Werner, Paolo Fanti

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Tumor induced osteomalacia (TIO) is a rare paraneoplastic syndrome characterized by renal phosphate wasting, hypophosphatemia, and osteomalacia. Fibroblast growth factor (FGF)-23, a phosphatonin i.e., phosphaturia-promoting hormone, is commonly implicated in the pathogenesis of TIO. However, very limited information is available about the circulating levels and clinical significance of other phosphatonins that are expressed by TIO-associated tumors. In addition, identification of the primary tumor constitutes a frequent major challenge in the management of TIO. Here, we report a patient with the clinical diagnosis of TIO with elevated blood levels of the phosphatonins FGF-23 and FGF-7; and extensive but unrewarding radiological search for the primary tumor. In selective venous sampling, both FGF-23 and FGF-7 displayed highest concentrations in the left femoral and iliac veins; although lateralization was much more pronounced for FGF-7 than FGF-23. This laboratory finding allowed us to focus on the left lower extremity as the likely location of the primary tumor. Our case is the first to show that FGF-7 can be analyzed in the circulation and used to assist in the diagnosis and localization of TIO-associated tumors.

Original languageEnglish (US)
Pages (from-to)57-68
Number of pages12
JournalClinical Nephrology
Volume85
Issue number1
DOIs
StatePublished - 2016

Fingerprint

Fibroblast Growth Factor 7
Neoplasms
Familial Hypophosphatemia
Hypophosphatemia
Iliac Vein
Paraneoplastic Syndromes
Osteomalacia
Femoral Vein
Oncogenic osteomalacia
fibroblast growth factor 23
Lower Extremity
Phosphates
Hormones
Kidney

Keywords

  • FGF-23
  • FGF-7
  • Phosphatonins
  • TIO

ASJC Scopus subject areas

  • Nephrology

Cite this

Tumor induced osteomalacia : Associated with elevated circulating levels of fibroblast growth factor-7 in addition to fibroblast growth factor-23. / Bansal, Shweta; Khazim, Khaled; Suri, Rajeev; Martin, DeAndra; Werner, Sherry; Fanti, Paolo.

In: Clinical Nephrology, Vol. 85, No. 1, 2016, p. 57-68.

Research output: Contribution to journalArticle

Bansal, Shweta ; Khazim, Khaled ; Suri, Rajeev ; Martin, DeAndra ; Werner, Sherry ; Fanti, Paolo. / Tumor induced osteomalacia : Associated with elevated circulating levels of fibroblast growth factor-7 in addition to fibroblast growth factor-23. In: Clinical Nephrology. 2016 ; Vol. 85, No. 1. pp. 57-68.
@article{451dd06328d94330be71c2f1831b6124,
title = "Tumor induced osteomalacia: Associated with elevated circulating levels of fibroblast growth factor-7 in addition to fibroblast growth factor-23",
abstract = "Tumor induced osteomalacia (TIO) is a rare paraneoplastic syndrome characterized by renal phosphate wasting, hypophosphatemia, and osteomalacia. Fibroblast growth factor (FGF)-23, a phosphatonin i.e., phosphaturia-promoting hormone, is commonly implicated in the pathogenesis of TIO. However, very limited information is available about the circulating levels and clinical significance of other phosphatonins that are expressed by TIO-associated tumors. In addition, identification of the primary tumor constitutes a frequent major challenge in the management of TIO. Here, we report a patient with the clinical diagnosis of TIO with elevated blood levels of the phosphatonins FGF-23 and FGF-7; and extensive but unrewarding radiological search for the primary tumor. In selective venous sampling, both FGF-23 and FGF-7 displayed highest concentrations in the left femoral and iliac veins; although lateralization was much more pronounced for FGF-7 than FGF-23. This laboratory finding allowed us to focus on the left lower extremity as the likely location of the primary tumor. Our case is the first to show that FGF-7 can be analyzed in the circulation and used to assist in the diagnosis and localization of TIO-associated tumors.",
keywords = "FGF-23, FGF-7, Phosphatonins, TIO",
author = "Shweta Bansal and Khaled Khazim and Rajeev Suri and DeAndra Martin and Sherry Werner and Paolo Fanti",
year = "2016",
doi = "10.5414/CN108596",
language = "English (US)",
volume = "85",
pages = "57--68",
journal = "Clinical Nephrology",
issn = "0301-0430",
publisher = "Dustri-Verlag Dr. Karl Feistle",
number = "1",

}

TY - JOUR

T1 - Tumor induced osteomalacia

T2 - Associated with elevated circulating levels of fibroblast growth factor-7 in addition to fibroblast growth factor-23

AU - Bansal, Shweta

AU - Khazim, Khaled

AU - Suri, Rajeev

AU - Martin, DeAndra

AU - Werner, Sherry

AU - Fanti, Paolo

PY - 2016

Y1 - 2016

N2 - Tumor induced osteomalacia (TIO) is a rare paraneoplastic syndrome characterized by renal phosphate wasting, hypophosphatemia, and osteomalacia. Fibroblast growth factor (FGF)-23, a phosphatonin i.e., phosphaturia-promoting hormone, is commonly implicated in the pathogenesis of TIO. However, very limited information is available about the circulating levels and clinical significance of other phosphatonins that are expressed by TIO-associated tumors. In addition, identification of the primary tumor constitutes a frequent major challenge in the management of TIO. Here, we report a patient with the clinical diagnosis of TIO with elevated blood levels of the phosphatonins FGF-23 and FGF-7; and extensive but unrewarding radiological search for the primary tumor. In selective venous sampling, both FGF-23 and FGF-7 displayed highest concentrations in the left femoral and iliac veins; although lateralization was much more pronounced for FGF-7 than FGF-23. This laboratory finding allowed us to focus on the left lower extremity as the likely location of the primary tumor. Our case is the first to show that FGF-7 can be analyzed in the circulation and used to assist in the diagnosis and localization of TIO-associated tumors.

AB - Tumor induced osteomalacia (TIO) is a rare paraneoplastic syndrome characterized by renal phosphate wasting, hypophosphatemia, and osteomalacia. Fibroblast growth factor (FGF)-23, a phosphatonin i.e., phosphaturia-promoting hormone, is commonly implicated in the pathogenesis of TIO. However, very limited information is available about the circulating levels and clinical significance of other phosphatonins that are expressed by TIO-associated tumors. In addition, identification of the primary tumor constitutes a frequent major challenge in the management of TIO. Here, we report a patient with the clinical diagnosis of TIO with elevated blood levels of the phosphatonins FGF-23 and FGF-7; and extensive but unrewarding radiological search for the primary tumor. In selective venous sampling, both FGF-23 and FGF-7 displayed highest concentrations in the left femoral and iliac veins; although lateralization was much more pronounced for FGF-7 than FGF-23. This laboratory finding allowed us to focus on the left lower extremity as the likely location of the primary tumor. Our case is the first to show that FGF-7 can be analyzed in the circulation and used to assist in the diagnosis and localization of TIO-associated tumors.

KW - FGF-23

KW - FGF-7

KW - Phosphatonins

KW - TIO

UR - http://www.scopus.com/inward/record.url?scp=84957884031&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84957884031&partnerID=8YFLogxK

U2 - 10.5414/CN108596

DO - 10.5414/CN108596

M3 - Article

C2 - 26521888

AN - SCOPUS:84957884031

VL - 85

SP - 57

EP - 68

JO - Clinical Nephrology

JF - Clinical Nephrology

SN - 0301-0430

IS - 1

ER -