Фосфопеническая остеомаляция опухолевого генеза: современные подходы к диагностике и лечению

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.

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