• Clinical Pain
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• v.20 no.2
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• pp.131-134
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• 2021

We report a rare case of anti-viral agent induced hypophosphatemic osteomalacia presented with localized and radicular pain. A 51-year-old man, who had been taking adefovir for chronic hepatitis, had experienced low back pain radiating to his right thigh for 2 years. With impression of lumbar disc herniation, he underwent magnetic resonance imaging and found multi-level disc herniation with facet joint synovial cysts. He received transforaminal epidural steroid injections, however, symptoms did not improve. To find other possible causes, additional tests were performed. Blood tests revealed hypophosphatemia and increased serum alkaline phosphatase, and osteoporosis was noted in dual-energy X-ray absorptiometry with multiple hot uptakes in bone scan. After replacement of adefovir to entecavir and supplement of phosphate and vitamin D, phosphate level and the clinical symptoms were improved. This is the first to report the presentation of osteomalacia due to anti-viral agent as radicular low back pain with facet synovial cysts.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.17 no.1
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• pp.279-286
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• 1987

The authors observed a patient who referred to the Department of Oral Radiology, due to diffuse skeletal pain, muscular weakness and unknown tumor mass on the buccal gingiva of upper right molar region. The patient was found to have peripheral reparative giant cell granuloma and osteomalacia. After removal of the tumor, the clinical, radiologic, and laboratory findings of the patient was rapidly normalized with remarkable improvement of bone pain. The results were as follows: 1. After removal of the tumor, the patient improved. the clinical findings such as bone pain, trismus. muscular weakness and he could walk. 2. In postoperative x-ray findings at 1 and 2 months intervals, the lamina dura of all dentition and bony trabeculae in upper and lower arches were regenerating and the bone density increased. 3. In periodic recall check, no occurrence of osteomalacia was existed and the laboratory findings of the patient showed gradual improvement.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.25 no.1
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• pp.141-150
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• 1995

종양유발성 골연화증은 종양에 의하여 생성된 활동성 펩티드호르몬과 유사한 물질이 골이나 위장관에 작용하여 칼슘대사와 인대사의 변화를 일으키거나, 정상적인 비타민 D대사에 장애를 일으킴으로써 2차적으로 발생되는 대사성 질환으로 알려져 있다. 이의 발생빈도는 매우 낮으며, 임상적으로는 체중과 신장의 감소, 전신적인 골격의 동통 및 근무력증과 병적 골절이 동반되어 나타난다. 방사선사진에서는 골소주의 전반적인 소실, 피질골의 비박, 위골절, 치조백선의 소실 등을 보이고, 실험실 소견에서는 혈청인의 농도와 신세뇨관에서 인의 재흡수율의 감소 및 혈청 알칼리성 인산화효소 농도의 상승이 관찰된다. 본질환은 종양이 제거되면 별도의 부가적인 치료 없이도 임상적, 방사선학적 소견 및 실험실 소견의 뚜렷한 개선을 보이므로 이의 치료에 있어서 정확한 진단이 매우 중요하다. 저자들은 전신적인 동통과 근무력증을 주소로 내원한 환자들에게서 발생된 종양유발성 골연화증 3예를 경험하였기에 문헌고찰과 함께 이를 보고하는 바이다.