Bone Health ECHO (Extension of Community Healthcare Outcomes) is a virtual community of practice that has been connecting healthcare professionals online once weekly for the past 10 years. A key component of each ECHO session is presentation and discussion of patient cases with diagnostic and treatment dilemmas. Here we present two wheelchair-bound female patients aged 47 years (Patient 1) and 34 years (Patient 2), both with type 1 diabetes mellitus (T1DM). They were admitted to our hospital due to multiple fractures and muscle weakness. Since age 8 years, both women suffered from T1DM. Patient 1 had extremely poor glycemic control over the whole period of diabetes with frequent cases of ketoacidosis (glycated hemoglobin [HbA1c] varied 10.0-14.2 %), with multiple end-stage complications of DM including anuria requiring hemodialysis from age 37 years. Patient 2 had minimal DM complications and maintained HbA1c within an individual goal (5.0-6.1 %). Both patients had low fasting phosphate and elevated alkaline phosphatase on laboratory evaluation. In the patient with anuria (Patient 1), after careful evaluation of all possible causes of hypophosphatemia, we found the most likely cause to be the effects of constantly repeated intracellular phosphate depletion due to poorly compensated T1DM. While achieving stable glucose control in hospital care, her phosphate levels gradually returned within the reference range. In the younger patient (Patient 2), tumor-induced osteomalacia (TIO) was diagnosed. After tumor removal her symptoms and laboratory results normalized. These cases illustrate two different causes of hypophosphatemia in patients with similar skeletal presentations in association with T1DM.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jocd.2024.101552DOI Listing

Publication Analysis

Top Keywords

years patient
12
patient
9
bone health
8
health echo
8
type diabetes
8
diabetes mellitus
8
age years
8
years
5
echo case
4
case report
4

Similar Publications

Drug Development.

Alzheimers Dement

December 2024

Fundacion Neuropolis, Zaragoza, Zaragoza, Spain.

Background: The therapeutic management of dementia with Lewy bodies (LBD) is a challenge given the high sensitivity to drugs in this disease. This is particularly sensitive with regard to the management of parkinsonism. In particular, treatment of motor symptoms with levodopa or dopaminergic agonists poses a risk of worsening cognitive and behavioral symptoms.

View Article and Find Full Text PDF

Drug Development.

Alzheimers Dement

December 2024

Clario, Philadelphia, PA, USA.

Background: Clinical outcome assessments (COAs) are an important part of clinical trials to measure what is meaningful to patients and caregivers. This study aimed to examine trends in Alzheimer's Disease (AD) COAs used in clinical trials, given the FDA's recent emphasis on patient-focused drug development and early AD.

Method: ClinicalTrials.

View Article and Find Full Text PDF

Drug Development.

Alzheimers Dement

December 2024

Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, Beijing, China.

Background: The DL-3-n-butylphthalide (NBP), a multi-target neuroprotective drug, improving cognitive impairment in patient with vascular cognitive impairment has been confirmed. The efficacy of NBP in patients with cognitive impairment due to Alzheimer's disease (AD) remains unknown. This study aimed to evaluate the efficacy and safety of NBP in patients with mild cognitive impairment (MCI) due to AD though a clinical randomized controlled trail.

View Article and Find Full Text PDF

Background: Our previous study identified that Sildenafil (a phosphodiesterase type 5 [PDE5] inhibitor) is a candidate repurposable drug for Alzheimer's Disease (AD) using in silico network medicine approach. However, the clinically meaningful size and mechanism-of-actions of sildenafil in potential prevention and treatment of AD remind unknown.

Method: We conducted new patient data analyses using both the MarketScan® Medicare with Supplemental database (n = 7.

View Article and Find Full Text PDF

Drug Development.

Alzheimers Dement

December 2024

Karolinska Institute, Stockholm, Södermanland and Uppland, Sweden.

Background: Novel anti-amyloid therapies (AAT) for Alzheimer's Disease (AD) have recently been approved in the United States, Japan and China, and are under regulatory review in Europe. Questions remain regarding the long-term effectiveness and value of these drugs when used in routine clinical practice. Data from follow-up studies will be important to inform their optimal use, including criteria for treatment initiation, monitoring strategies, stopping rules, pricing and reimbursement considerations.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!