• Internal medicine · Jan 2023

    Case Reports

    A Bone Histomorphometric Analysis of Hypophosphatasia-related Osteoporosis after Teriparatide Treatment.

    • Hiroki Mizuno, Naoki Sawa, Akinari Sekine, Noriko Inoue, Yuki Oba, Daisuke Ikuma, Masayuki Yamanouchi, Eiko Hasegawa, Tatsuya Suwabe, Hisanori Suzuki, Junichi Hoshino, and Yoshifumi Ubara.
    • Nephrology Center + the Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan.
    • Intern. Med. 2023 Jan 1; 62 (1): 757975-79.

    AbstractA 79-year-old man was admitted with a compression fracture of the first lumbar vertebra. His alkaline phosphatase (ALP) level was 35 IU/L, and his dual energy X-ray absorptiometry T score was -3.7 standard deviations, indicating osteoporosis. A genetic analysis showed a mutation of the alkaline phosphatase biomineralization-associated gene encoding tissue-nonspecific alkaline phosphatase. Hypophosphatasia-related osteoporosis was diagnosed. Alendronate, teriparatide, and minodronate were administered in that order. The ALP level increased during teriparatide use. A bone biopsy performed after three years of teriparatide treatment showed that cancellous bone was adynamic. In cortical bone, tetracycline double-labeling indicates enhanced bone formation. Teriparatide may thus be a viable treatment option even in patients with hypophosphatasia.

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