Osteomalacia due to a bladder reconstruction performed 35 years previously
Misa Hirukawa1, Hiraku Funakoshi, Tomoko Tsukamoto
1Department of General Medicine, Chiba University Hospital, Japan. misa-hirukawa@swan.ocn.ne.jp
Internal Medicine (Tokyo, Japan)
|August 7, 2012
Summary
A man developed osteomalacia 35 years after bladder reconstruction due to metabolic acidosis. Treatment with sodium hydrogen carbonate improved his symptoms and electrolyte levels, highlighting the need for regular blood tests in such patients.
Area of Science:
- Nephrology
- Endocrinology
- Bone Metabolism
Background:
- Bladder reconstruction surgery can lead to long-term complications.
- Metabolic acidosis is a potential complication of certain surgical procedures.
- Osteomalacia is a condition characterized by softening of the bones.
Observation:
- A 54-year-old male presented with 18 months of progressive chest and back pain.
- The patient had undergone bladder reconstruction 35 years prior to symptom onset.
- Initial investigations revealed hyperalkalinephosphatemia and elevated serum chloride levels.
Findings:
- Osteomalacia secondary to metabolic acidosis was suspected based on laboratory findings.
- Bone scintigraphy confirmed the diagnosis of osteomalacia.
- The patient's symptoms and electrolyte imbalances resolved with oral sodium hydrogen carbonate treatment.
Implications:
- Serum chloride level measurement is a simple and effective tool for acidosis evaluation.
- Regular blood testing is crucial for early detection of complications in patients with a history of bladder reconstruction.
- This case underscores the importance of long-term patient monitoring after complex urological surgeries.
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