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J Bone Miner Metab. 2009;27(4):392-401. doi: 10.1007/s00774-009-0079-1. Epub 2009 Jun 6.

Hypophosphatemia: the common denominator of all rickets.

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  • 1Meyer Children's Hospital, Rambam Medical Center, POB 9602, 31096, Haifa, Israel. d_tiosano@rambam.health.gov.il


Rickets is a disease of the hypertrophic chondrocytes in the growth plate and is caused by hypophosphatemia-a derived defect in terminal chondrocyte apoptosis. This highlights the critical role of phosphorous in cartilage and bone metabolism. This review shows the role of phosphorous metabolism, transport and function in maintaining phosphorous supply to the growth plate, bone osteoblast and the kidney. Given that phosphorous is the common denominator of all rickets, this review proposes a new classification for the differential diagnosis of rickets, which is based on the mechanisms leading to hypophosphatemia-high PTH activity, high FGF23 activity or renal phosphaturia.

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