Tumor-induced osteomalacia (TIO) is an uncommon type of osteomalacia associated with phosphaturic mesenchymal tumors (PMTs). Due to nonspecific symptoms, the diagnosis and appropriate management of the disease is often delayed for many years. Involvement of spine with TIO associated tumors is exceedingly rare. We present a 53-year-old woman with a 10-year history of bone pain, muscle weakness and multiple bone fractures that markedly impaired her quality of life. Biochemical evaluation revealed hypophosphatemia due to renal phosphate wasting and elevated plasma fibroblast growth factor 23 (FGF-23) concentration indicating PMT. It was found using 68Ga DOTA TOC PET/CT scan in the vertebral body L2. The patient underwent surgical resection of the tumor. Postoperatively, there was a significant decrease in phosphaturia, normalization of serum phosphate, 1.25 dihydroxyvitamin D and plasma FGF23 concentration. Thereafter the patient's condition markedly improved concerning her motility and basic daily activities. This case report demonstrates the first known case of TIO in the Slovakia and points to a long way from onset of symptoms toward correct diagnosis and successful surgical management.

• Publikační typ
• kazuistiky MeSH

Tumorom indukovaná osteomalácia (TIO) je vzácny paraneoplastický syndróm spôsobený typicky malými endokrinnými nádormi, ktoré vylučujú fibroblastový rastový faktor 23 (FGF23). TIO je klinicky charakterizovaná progresívnou muskuloskeletálnou bolesťou, únavou, slabosťou proximálnych svalov a viacnásobnými zlomeninami, ktoré vedú k dlhodobej invalidite. Kvôli nešpecifickým symptómom ochorenia môže trvať aj niekoľko rokov, kým sú pacienti správne diagnostikovaní a liečení a preto je dôležité zvýšiť povedomie o tomto vzácnom paraneoplastickom syndróme.

Tumor induced osteomalacia (TIO) is a rare paraneoplastic syndrome typically caused by small endocrine tumors that secrete fibroblast growth factor 23(FGF23). TIO is clinically characterized by progressive muskuloskeletal pain, fatigue, proximal muscle weakness, and multiple fractures that lead to long-term disability. Due to the non-specific symptoms of the disease, it may take several years for them to be properly diagnosed and treated, so it is important to better inform about this rare paraneoplastic syndrome. Key word: FGF23, hypophosphataemia, tumor induced osteomalacia.

• MeSH
• diferenciální diagnóza MeSH
• fibroblastové růstové faktory škodlivé účinky   MeSH
• hypofosfatemie MeSH
• lidé MeSH
• mezenchymom MeSH
• opomíjené nemoci diagnóza   terapie   MeSH
• osteomalacie * diagnóza   terapie   MeSH
• paraneoplastické endokrinní syndromy * diagnóza   terapie   MeSH
• vzácné nemoci diagnóza   terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

Aphanomyces astaci, the crayfish plague pathogen, first appeared in Europe in the mid-19(th) century and is still responsible for mass mortalities of native European crayfish. The spread of this parasite across the continent is especially facilitated by invasive North American crayfish species that serve as its reservoir. In France, multiple cases of native crayfish mortalities have been suggested to be connected with the presence of the signal crayfish Pacifastacus leniusculus, which is highly abundant in the country. It shares similar habitats as the native white-clawed crayfish Austropotamobius pallipes and, when infected, the signal crayfish might therefore easily transmit the pathogen to the native species. We investigated the prevalence of A. astaci in French signal crayfish populations to evaluate the danger they represent to local populations of native crayfish. Over 500 individuals of Pacifastacus leniusculus from 45 French populations were analysed, plus several additional individuals of other non-indigenous crayfish species Orconectes limosus, O. immunis and Procambarus clarkii. Altogether, 20% of analysed signal crayfish tested positive for Aphanomyces astaci, and the pathogen was detected in more than half of the studied populations. Local prevalence varied significantly, ranging from 0% up to 80%, but wide confidence intervals suggest that the number of populations infected by A. astaci may be even higher than our results show. Analysis of several individuals of other introduced species revealed infections among two of these, O. immunis and P. clarkii. Our results confirm that the widespread signal crayfish serves as a key reservoir of Aphanomyces astaci in France and therefore represents a serious danger to native crayfish species, especially the white-clawed crayfish. The prevalence in other non-indigenous crayfish should also be investigated as they likely contribute to pathogen transmission in the country.

• MeSH
• Alzheimerova nemoc diagnóza   metabolismus   MeSH
• fluorodeoxyglukosa F18 diagnostické užití   MeSH
• fyziologie buňky * MeSH
• glukosa metabolismus   MeSH
• kognitivní dysfunkce diagnóza   metabolismus   MeSH
• krysa rodu rattus MeSH
• lidé středního věku MeSH
• lidé MeSH
• longitudinální studie MeSH
• mapování mozku * MeSH
• myši MeSH
• následné studie MeSH
• neuronové sítě (počítačové) MeSH
• neurozobrazování * MeSH
• pozitronová emisní tomografie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• studie případů a kontrol MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• myši MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH