Opsismodysplasia: Phosphate Wasting Osteodystrophy Responds to Bisphosphonate Therapy
CLINICAL CASE STUDY published: 22 June 2015 doi: 10.3389/fped.2015.00048 Opsismodysplasia: phosphate wasting osteodystrophy responds to bisphosphonate therapy Ansab Khwaja1, Shawn E. Parnell2, Kathryn Ness3, Viviana Bompadre1 and Klane K. White1* 1 Orthopedics and Sports Medicine, Seattle Children’s Hospital, University of Washington, Seattle, WA, USA, 2 Department of Radiology, Seattle Children’s Hospital, University of Washington, Seattle, WA, USA, 3 Division of Endocrinology, Department of Pediatrics, Seattle Children’s Hospital, University of Washington, Seattle, WA, USA We present two siblings affected with opsismodysplasia (OPS), a rare skeletal dysplasia caused by mutations in the inositol polyphosphate phosphatase-like 1 gene. The skeletal findings include short stature with postnatal onset micromelia, marked platyspondyly, squared metacarpals, delayed skeletal ossification, metaphyseal cupping, and postnatal micromelia. Respiratory compromise, delayed ambulation, and progressive lower extremity deformities are described. The severity of findings is variable. Renal phosphate wasting Edited by: Jeff Martus, is associated with severe bone demineralization and a more severe phenotype. This Vanderbilt Children’s Hospital, USA report represents the first described cases of opsismodysplasia treated with intravenous Reviewed by: bisphosphonate (pamidronate). Surgical management for lower extremity deformities Jason Troy Rhodes, University of Colorado, USA associated with OPS is also reviewed. Ryan D. Muchow, Level of Evidence: IV Case series University of Kentucky, USA Christine Ann Ho, Keywords: opsismodysplasia, metabolic bone disease, skeletal dysplasias, scoliosis, genu varum, bisphosphonates Texas Scottish Rite Hospital, USA *Correspondence: Klane K. White, Orthopedics and Sports Medicine, Introduction Seattle Children’s Hospital, University of Washington, 4800 Sand Point Opsismodysplasia (OPS) is a rare autosomal recessive skeletal dysplasia associated with delayed Way, OA.9.120, Seattle, WA, USA bone maturation and micromelia (1, 2).
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