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骨软化是一种代谢性骨病,特征为骨痛、肌无力和新生骨基质钙化衰退。其病因有:维生素 D 缺乏或代谢异常、肾脏病、家族的和散在的血磷浓度过低、磷酸酶过少以及伴有固形组织肿瘤的骨软化。由肿瘤形成所引起的肿瘤性骨软化独具的特征是,彻底摘除肿瘤后骨软化即行消退。肿瘤组织导致骨软化的机理有二:一是由磷酸盐尿质分泌引起的,另一是以肿瘤为媒介造成维生素 D代谢异常而引起。我们曾观察了一患有肿瘤性骨软化的儿童于肿瘤摘除术前后维生素 D代谢变化的情况。现报告如下。病例报告某15岁男孩,住佛罗里达州,主诉肌无力。检验结果表明:血清钙10.1毫克/100毫升;血清磷2.1毫克/100毫升;硷性磷酸酶618单位/升(正常为20—90单位/升)。临床诊断为不明病因的肌强直。14个月后,病人显示出进行性肌无力和弥漫性骨痛,而
Osteomalacia is a metabolic bone disease characterized by bone pain, muscle weakness, and new bone matrix calcification decline. The causes are: vitamin D deficiency or metabolic abnormalities, kidney disease, family and scattered serum phosphorus concentrations, hypophosphatases, and osteomalacia with solid tissue tumors. The unique feature of tumorous osteomalacia caused by tumor formation is that osteomalacia disappears when the tumor is completely removed. The mechanism of osteomalacia caused by tumor tissue is twofold: one is caused by the secretion of phosphate urine, and the other is caused by abnormal vitamin D metabolism caused by tumors. We have observed the changes of vitamin D metabolism in children with neoplastic osteomalacia before and after tumor removal. The report is as follows. Case report A 15-year-old boy, living in Florida, complained of muscle weakness. The test results showed: serum calcium 10.1 mg/100 ml; serum phosphorus 2.1 mg/100 ml; alkaline phosphatase 618 units/liter (normally 20-90 units/liter). The clinical diagnosis of myotonia is of unknown cause. After 14 months, the patient showed progressive muscle weakness and diffuse bone pain.