PEDIATRICS Vol. 52 No. 3 September 1973, pp. 432-434
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ONCOGENOUS RICKETS: POSSIBLE ELABORATION BY A TUMOR OF A HUMORAL SUBSTANCE INHIBITING TUBULAR REABSORPTION OF PHOSPHATE

Harold E. Harrison M.D.1

1 Department of Pediatrics, Baltimore City Hospitals, Johns Hopkins University School of Medicine, Baltimore, Maryland

Pollack et al.1 have introduced the intriguing speculation that some rare tumors of mesenchymal origin release a humoral substance which inhibits tubular reabsorption of phosphate and through the resultant profound hypophosphatemia causes vitamin D unresponsive rickets and osteomalacia. There have been sufficient reports of hypophosphatemic vitamin D-resistant rickets and osteomalacia cured by removal of tumors of bone or soft tissue to support the inference that there is a causal relationship between such tumors and the hypophosphatemic rickets. The demonstration of marked reduction of tubular reabsorption of phosphate in such a patient and the dramatic rapid return of tubular reabsorption of phosphate to normal following tumor excision is certainly circumstantial evidence of the secretion by the tumor of an inhibitor of phosphate retrieval by the renal tubule.




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