Title 1. BSCKII. Tran Ngoc Huu Duc (0404).pdf ✅

Tumor induced osteomalacia: case report and literature review Tran Ngoc Huu Duc, Huynh Phan Phuc Linh, Nguyen Dinh Khoa
History • Male patient, born 1990, gardener, living at Dong Nai • Late 2019: lower back pain, worsen at night, muscle spasm while sleeping, morning movement slightly alleviated the pain • Diagnosed with ankylosing spondylitis, but stop treatment due to lack of efficacy • Herbal medicinal treatment was pursued, but without improvement • By 2022, noticed a 1 cm painless mass in the left thigh. • Early 2024: rapid progressive weakness, severe widespread bone pain → wheelchaired • Height in 2019: 1.68m, decreased down to 1.53m by early 2024
Physical examination (May 2024) • Emaciated general condition • Wheelchaired • Kyphoscoliosis • Muscle strength in all four limbs 3/5 • Joints not swollen • No deformities in the head, face, neck, or extremities
Lab tests (May 2024) • HGB 124 g/L, MCV 68.3 fL, WBC 7.2 G/L, PLT 195 G/L • ESR 3 mm/h, CRP 0.9 mg/L • ĐH 93.8 mg/dL, ALT 20.8 U/L, AST 30. U/L, BUN 10.8 mg/dL, creatinine 0.86 mg/dL • Na 140.7 mmol/L, K 4.34 mmol/L, Cl 106.8 mmol/L, Ca ionized 1.03 mmol/L • Inorganic Phosphorus 2.8 mg/L • CPK 109 U/L, LDH 192.98 U/L • TPTNT pH 5.0 , SG 1.025, glucose (-), pro (-), blood (-), leuko (-), nitrite (-) • Cardioecho: normal heart chambers, normal valves, normal pulmonary artery pressure, EF 62% • AP pelvis X-ray:blurred edge of bilateral SI joint • HLA-B27 negative • DXA: T-scoreneck -5.3, T-scoretotal hip -4.6, T-scorelumbar -4.6