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Secondary hyperparathyroidism in osteomalacia.

N C Thalassinos, S Wicht, G F Joplin

    British Medical Journal
    |January 10, 1970
    PubMed
    Summary

    Osteomalacia diagnosis can be challenging. The 24-hour stable strontium space measurement is the most sensitive biochemical screening test for osteomalacia, outperforming phosphaturia.

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    Area of Science:

    • Biochemistry
    • Endocrinology
    • Radiology

    Background:

    • Osteomalacia is a bone disorder characterized by impaired mineralization.
    • Secondary hyperparathyroidism is a common complication of osteomalacia.
    • Accurate biochemical markers for diagnosis are crucial.

    Purpose of the Study:

    • To investigate biochemical and radiological markers for osteomalacia and secondary hyperparathyroidism.
    • To evaluate the utility of phosphaturia and strontium space measurement in diagnosing osteomalacia.

    Main Methods:

    • Histological confirmation of osteomalacia in 21 patients.
    • Assessment of serum calcium, phosphate excretion index, serum alkaline phosphatase, and phalangeal erosions.
    • Measurement of 24-hour stable strontium space.

    Main Results:

    • Phosphate excretion index and alkaline phosphatase showed a strong correlation (r = +0.84).
    • Absence of manifest secondary hyperparathyroidism was noted in some patients, possibly due to impaired parathyroid hormone release.
    • Phosphaturia was not a reliable indicator for detecting osteomalacia.

    Conclusions:

    • The 24-hour stable strontium space measurement is the most sensitive single biochemical screening test for osteomalacia.
    • Phosphaturia is not a useful diagnostic tool for osteomalacia.
    • Further research into parathyroid hormone dynamics in osteomalacia is warranted.

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