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Papel da histomorfometria óssea no diagnóstico diferencial da osteomalacia

Osteomalacia is a metabolic bone disease with a deficient bone mineralization characterized histomorphometrically by an osteoid thickness (O.Th) greater than 15mum and a mineralization lag time (MLT) longer than 100 days. The main etiologies are deficient activity of vitamin D and primary hypophosphatemia. In this study we presented 14 patients with osteomalacia diagnosed clinically and through laboratory findings and divided into 2 groups: vitamin D deficient (n=6) and primary hypophosphatemia (n=8). MLT and O.Th were increased in all patients. Bone erosion surfaces were increased in the vitamin D deficient group. In the hypophosphatemic patients, the erosion surfaces were not found in 6 patients, increased in one and normal in one. It is concluded that the diagnosis of osteomalacia can be defined through the measurement of the histomorphometric parameters of bone formation while bone reabsorption parameters can suggest a possible etiology.

Osteomalacia; Vitamin D deficiency; Hypophosphatemia; Bone remodeling; Metabolic bone disease


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