mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2024-5-7-15mrj-1634Research ArticleЛЕКЦИЯLECTUREФосфопеническая остеомаляция опухолевого генеза: современные подходы к диагностике и лечениюTumor-induced phosphopenic osteomalacia: modern approaches to diagnostics and treatmenthttps://orcid.org/0000-0001-9152-3234КондрашовА. А.KondrashovA. A.

Артем Александрович Кондрашов

117513, Москва, ул. Островитянова 1

Artem Aleksandrovich Kondrashov

1, Ostrovitianov Street, Moscow 117997

kaartem@gmail.comhttps://orcid.org/0000-0001-8266-6022АндрияшкинаД. Ю.AndriyashkinaD. Yu.

117513, Москва, ул. Островитянова 1

1, Ostrovitianov Street, Moscow 117997

https://orcid.org/0000-0001-6890-8777ДемидоваН. А.DemidovaN. A.

117513, Москва, ул. Островитянова 1

1, Ostrovitianov Street, Moscow 117997

https://orcid.org/0000-0002-0457-8921СаакянЮ. М.SahakyanYu. M.

117513, Москва, ул. Островитянова 1

1, Ostrovitianov Street, Moscow 117997

https://orcid.org/0000-0002-7410-9784КлименкоА. А.KlimenkoA. A.

117513, Москва, ул. Островитянова 1

1, Ostrovitianov Street, Moscow 117997

ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава РоссииРоссияPirogov Russian National Research Medical University, Ministry of Health of RussiaRussian FederationФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава РоссииРоссияPirogov Russian National Research Medical University, Ministry of Health of RussiaRussian Federation202419102024185715Copyright © Кондрашов А.А., Андрияшкина Д.Ю., Демидова Н.А., Саакян Ю.М., Клименко А.А., 20242024Кондрашов А.А., Андрияшкина Д.Ю., Демидова Н.А., Саакян Ю.М., Клименко А.А.Kondrashov A.A., Andriyashkina D.Y., Demidova N.A., Sahakyan Y.M., Klimenko A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://mrj.ima-press.net/mrj/article/view/1634

Фосфопеническая остеомаляция (ФПОМ) – редкий вариант паранеопластического синдрома, возникающий при синтезе опухолью фактора роста фибробластов (ФРФ) 23. Под действием ФРФ23 происходит снижение реабсорбции фосфатов, уровня кальцитриола, что приводит к развитию выраженной гипофосфатемии и гипокальциемии. Синтез ФРФ23 ассоциирован преимущественно с доброкачественными мезенхимальными опухолями, однако описан и для злокачественных новообразований. Основными клиническими проявлениями ФПОМ являются генерализованная миалгия и миопатия, оссалгия, патологические переломы и др. Диагностика заболевания предполагает поэтапное обследование с применением методов визуализации, основанных на идентификации рецепторов соматостатина, поскольку именно они обладают самой высокой чувствительностью для выявления новообразований, вызывающих остеомаляцию. Хирургическое вмешательство, безусловно, является предпочтительным методом лечения. К перспективным нехирургическим методам можно отнести лечение буросумабом и аналогами соматостатина.

Phosphopenic osteomalacia (PPOM) is a rare variant of paraneoplastic syndrome caused by tumor synthesis of fibroblast growth factor 23 (FGF23). FGF23 secretion leads to a decrease in phosphate reabsorption and calcitriol levels, which leads to the development of severe hypophosphataemia and hypocalcaemia. FGF23 synthesis is predominantly associated with benign mesenchymal tumors, but has also been described in malignant neoplasms. The main clinical manifestations of PPOM are generalized myalgias and myopathy, ostealgia, pathological fractures, etc. The diagnosis of the disease requires a step-by-step investigation using somatostatin receptor-based imaging techniques, as these have the highest sensitivity for the detection of neoplasms causing osteomalacia. Surgical intervention is clearly the treatment of choice. Promising non-surgical methods include treatment with burosumab and somatostatin analogues.

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The authors declare that there are no conflicts of interest present.