Mild Phosphate Diabetes in Adults

Abstract

Phosphate diabetes has been considered rare and to occur almost exclusively in children. Upon examination of adult patients with rheumatic or kidney diseases it was found that the combination of hypophosphatemia and hyperphosphaturia is not so rare. Adult patients [24] of this type, found during 6 mo. were investigated. Their mean serum phosphorus concentration was 0.7 mM (range 0.5-0.8). Mean phosphate clearance was 31 ml/min per 1.73 m2 (range 16-51). The diagnoses were myalgia, dorsalgia (n = 7), papillitis calcificans (n = 5), prostatitis or prostate accretions (n = 4), dizziness (n = 2), kidney stones, tubular defect, interstitial nephritis, medullary sponge kidney (1 case each), 2 patients had transplanted kidneys. Asthenia was a common additional diagnosis. The patients'' complaints were pain in the muscles, joints, bones (18 cases), tiredness (10 cases), dizziness (8 cases), shakiness, numbness, burning sensation (7 cases), tenderness in the muscles and bones (the princess-on-the-pea syndrome) (7 cases). The most common findings upon examination were bone tenderness (13 cases), reduced manual power (8 cases), positive Romberg test (3 cases), slight muscle atrophy (2 cases), waddling gait (2 cases). The most common findings encountered in the laboratory, besides hypophosphatemia and hyperphosphaturia, were high pH in the urine, hyperaminoaciduria, and phosphate crystals in dried urine.