Unlabelled: Low serum alkaline phosphatase (ALP) was found in 9% of patients attending an osteoporosis clinic, 0.6% of hospital patients, and 2/22 with an atypical femoral fracture. Hypophosphatasia was diagnosed in 3% of osteoporosis clinic patients with low ALP. Low ALP is a screening tool for hypophosphatasia, a condition potentially aggravated by antiresorptive therapy.
Introduction: Hypophosphatasia (HPP) is an inherited disorder associated with impaired primary mineralisation of osteoid (osteomalacia). HPP may be misdiagnosed as osteoporosis, a reduction in the volume of normally mineralized bone. Both illnesses may result in fragility fractures, although stress and atypical fractures are more common in HPP. Antiresorptive therapy, first-line treatment for osteoporosis, is relatively contraindicated in HPP. Misdiagnosis and mistreatment can be avoided by recognising a low serum alkaline phosphatase (ALP). Our aim was to determine the prevalence of a low ALP (< 30 IU/L) in patients attending an osteoporosis clinic, in a hospital-wide setting, and in a group of patients with atypical femoral fractures (AFF).
Methods: This was a retrospective study of patients attending an osteoporosis clinic at a tertiary hospital during 8 years (2012-2020). Patients were categorised into those with a transiently low ALP, those with low ALP on ≥ 2 occasions but not the majority of measurements, and those with a persistently low ALP. ALP levels were also assessed in hospital-wide records and a group of patients with AFF.
Results: Of 1839 patients attending an osteoporosis clinic, 168 (9%) had ≥ 1 low ALP, 50 (2.7%) had low ALP for ≥ 2 months, and seven (0.4%) had persistently low ALP levels. HPP was diagnosed in five patients, four of whom had persistently low ALP levels. The prevalence of HPP was 0.3% in the osteoporosis clinic and 3% in patients with ≥ 1 low ALP. Low ALP occurred in 0.6% of all hospital patients and 2/22 with AFF.
Conclusion: Persistently low ALP in osteoporosis clinic attendees is easy to identify and signals the possibility of hypophosphatasia, a condition that may be mistaken for osteoporosis and incorrectly treated with antiresorptive therapy.
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http://dx.doi.org/10.1007/s00198-022-06597-3 | DOI Listing |
BMC Pregnancy Childbirth
December 2024
Department of Obstetrics and Gynecology, Zagazig University, zagazing, Egypt.
Background: Preeclampsia is a severe pregnancy complication affecting 2-8% of pregnancies globally, contributing to substantial maternal and fetal morbidity and mortality. Vitamin D deficiency has been associated with an increased risk of preeclampsia, yet the efficacy of its supplementation during pregnancy in reducing preeclampsia incidence remains uncertain.
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BMC Pediatr
December 2024
Department of Pediatrics, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.
Background: Fulminant virus-associated encephalopathy (VAE) is a rare complication of viral infection that presents as acute brain dysfunction and requires respiratory support and/or vasoactive agents. However, the mechanism of VAE is undetermined. The mortality rate is high since there is no specific treatment for fulminant VAE.
View Article and Find Full Text PDFBMC Cardiovasc Disord
December 2024
Department of cardiovascular medicine, Chengdu Seventh People's Hospital, No.1188 Shuangxing Avenue, Chengdu city, 610200, Sichuan Province, China.
Background: Heart failure with preserved ejection fraction (HFpEF) poses a significant clinical challenge, especially in older patients with HT. This study aimed to identify the factors influencing HFpEF occurrence in elderly patients with HT.
Methods: Elderly patients with HT were categorized into two groups: no HFpEF group and HFpEF group based on HFpEF diagnosis.
Methods Mol Biol
December 2024
UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Mass spectrometry-based proteomics is widely applied to human blood serum or plasma in the search of biomarkers for various diseases. However, the enormous complexity and dynamic range of protein concentrations in these samples render a significant analytical challenge, particularly for detecting low-abundance candidate biomarkers. As a result, strategies for enriching low-abundance proteins and improving their identification in serum or plasma proteomics are commonly used.
View Article and Find Full Text PDFOsteoporos Int
December 2024
Department of Orthopaedics, West Virginia University, PO Box 9196, Morgantown, WV, 26506, USA.
Atraumatic bilateral femoral neck fractures are rare, especially in younger patients and those without significant comorbidities. However, pregnant individuals appear to be at increased risk due to normal physiological changes in calcium balance, leading to transient osteoporosis of the hip. In these individuals, calcium and bone mineral density are generally decreased, reflecting the calcium demands of the developing fetus.
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