Lack of Sustained Response to Teriparatide in a Patient with Adult Hypophosphatasia
Claudia Gagnon, Natalie A Sims, Steven Mumm, Sybil A McAuley, Caroline Jung, Ingrid J Poulton, Kong Wah Ng, Peter R Ebeling
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM | ENDOCRINE SOC | Published : 2010
INTRODUCTION: Hypophosphatasia (HPP) is a rare genetic disorder characterized by low serum alkaline phosphatase (ALP) and defective bone mineralization predisposing to poorly healing pseudofractures and fractures. Experience with teriparatide in HPP is limited. METHODS: A 53-yr-old woman was diagnosed with HPP on the basis of repeatedly low serum ALP (6-8 IU/liter; normal, 30-120 IU/liter), high urine phosphoethanolamine (PEA) and serum pyridoxal 5'-phosphate (PLP) concentrations, and pseudofractures on the lateral aspect of both proximal femurs. Teriparatide (20 microg/d sc) was initiated 4 months after surgery for a painful nonhealing left femoral fracture sustained after minimal trauma. R..View full abstract
Awarded by Australian National Health and Medical Research Council (NHMRC) Program
This work was supported by the Australian National Health and Medical Research Council (NHMRC) Program Grant 345401 (to N.A.S. and K.W.N.). N.A.S. is supported by a NHMRC (Australia) Senior Research Fellowship. C. G. is supported by a scholarship from Universite Laval, Quebec, Canada.