Nutritional rickets in children, particularly of Asian immigrants to the U.K., has been well documented over the past 20 years. Its incidence among infafits whose parents are Rastafarians of West Indian origin has not previously been described. In a 3-month period four cases of florid nutritional rickets were discovered at this hospital, and a new 'at-risk' group may have been identified.

症例は19歳の女性で，1歳時にX染色体優性低リン血症性くる病と診断され，活性型ビタミンD3製剤とリン製剤による加療を開始した．5年前より血清Ca，intact-PTH高値を認め，三次性副甲状腺機能亢進症の診断で当科へ紹介された．手術は先ず腫大腺である左上副甲状腺を摘出し，その尾側に左下副甲状腺を疑う所見を認め，摘出した後に術中迅速病理診断で副甲状腺の診断を得た．2腺とも副甲状腺過形成と診断した．術後血清Ca値，intact-PTH値は正常化した．長期間のリン製剤の投与により，その過程で副甲状腺機能亢進をきたすことがある．副甲状腺が自律性を有し，不可逆的にPTHの異常分泌を行う病態を三次性副甲状腺機能亢進症と呼ぶ．その治療法として，副甲状腺摘出術が挙げられる．複数腺の過形成を伴うことが多いが，一側検索による腫大腺の摘出で治癒しえた．患者背景を鑑み，慎重な手術適応，術式の検討が必要である．

UNLABELLED Renal control of systemic phosphate homeostasis is critical as evident from inborn and acquired diseases causing renal phosphate wasting. At least three transport proteins are responsible for renal phosphate reabsorption: NAPI-IIa (SLC34A1), NAPI-IIc (SLC34A3) and PIT-2 (SLC20A2). These transporters are highly regulated by various cellular mechanisms and factors including acid-base s...

Purpose of review—High levels of fibroblast growth factor 23 (FGF23) cause rare disorders of hypophosphatemic rickets and are a risk factor for cardiovascular disease and death in patients with chronic kidney disease (CKD). Despite major advances in understanding FGF23 biology, fundamental aspects of FGF23 regulation in health and in CKD remain mostly unknown. Recent findings—Autosomal dominant...