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Oris C, Lautrette A, Dougé A, Bouraima F, Kahouadji S, Pickering ME, Garrouste C, Gagnière J, Guièze R, D'Ostrevy N, Futier E, Grobost V, Buisson A, Batisse M, Bouillon-Minois JB, Pereira B, Durif J, Sapin V, Bouvier D. Prevalence of FGF23 elevation in patients with hypophosphatemia. Clin Chim Acta 2024; 554:117782. [PMID: 38224930 DOI: 10.1016/j.cca.2024.117782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/28/2023] [Accepted: 01/10/2024] [Indexed: 01/17/2024]
Abstract
BACKGROUND AND AIMS To investigate the contribution of FGF23 in explaining the cases of hypophosphatemia observed in clinical practice, we aimed to determine for the first time the prevalence of FGF23 elevation in patients with hypophosphatemia and to describe the different mechanisms of FGF23-related hypophosphatemic disorders. MATERIALS AND METHODS We performed a prospective, observational, multicenter, cohort study of 260 patients with hypophosphatemia. Blood measurements (PTH, 1,25-dihydroxyvitamin D, bone alkaline phosphatase, 25-hydroxyvitamin D, and FGF23) were performed on a Liaison XL® (DiaSorin) analyzer. RESULTS Primary elevation of FGF23 (>95.4 pg/mL) was reported in 10.4% (95CI: 7.0-14.7) of patients (n = 27) with hypophosphatemia, suggesting that at least 1 in 10 cases of hypophosphatemia was erroneously attributed to an etiology other than FGF23 elevation. Patients with elevated blood FGF23 were grouped according to the etiology of the FGF23 elevation. Thus, 10 patients had a renal pathology, chronic kidney disease or post-renal transplantation condition. The remaining patients (n = 17) had the following etiologies: malignancies (n = 9), benign pancreatic tumor (n = 1), post-cardiac surgery (n = 4), cirrhosis (n = 2), and chronic obstructive pulmonary disease (n = 1). CONCLUSION In order to improve patient management, it seems essential to better integrate plasma FGF23 measurement into the routine evaluation of hypophosphatemia.
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Affiliation(s)
- Charlotte Oris
- Biochemistry and Molecular Genetics Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; Clermont Auvergne University, CNRS, INSERM, iGReD, Clermont-Ferrand, France
| | - Alexandre Lautrette
- Department of Intensive Care Medicine, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Aurore Dougé
- Department of Oncology, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Farouk Bouraima
- Biochemistry and Molecular Genetics Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Samy Kahouadji
- Biochemistry and Molecular Genetics Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; Clermont Auvergne University, CNRS, INSERM, iGReD, Clermont-Ferrand, France
| | - Marie-Eva Pickering
- Rheumatology Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Cyril Garrouste
- Department of Nephrology, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Johan Gagnière
- Department of Digestive and Hepatobiliary Surgery, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Romain Guièze
- Department of Clinical Hematology, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Nicolas D'Ostrevy
- Department of Cardiac Surgery, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Emmanuel Futier
- Department of Perioperative Medicine, Anesthesia & Critical Care, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Vincent Grobost
- Department of Internal Medicine, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Anthony Buisson
- Department of Hepato-Gastroenterology, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Marie Batisse
- Department of Oncology, Centre Jean Perrin, 63000 Clermont-Ferrand, France
| | | | - Bruno Pereira
- Biostatistics Unit (DRCI) Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Julie Durif
- Biochemistry and Molecular Genetics Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Vincent Sapin
- Biochemistry and Molecular Genetics Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; Clermont Auvergne University, CNRS, INSERM, iGReD, Clermont-Ferrand, France
| | - Damien Bouvier
- Biochemistry and Molecular Genetics Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; Clermont Auvergne University, CNRS, INSERM, iGReD, Clermont-Ferrand, France.
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Çelik DŞ, Ayar K, Ermurat S, Üstündağ Y. Fibroblast growth factor 23 (Fgf23) levels and their relationship with disease activity, bone mineral density, and radiological damage score in patients with rheumatoid arthritis: a single center case–control study. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2022. [DOI: 10.1186/s43166-022-00152-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
There is limited and conflicting information on Fgf23 levels and their relationship with bone loss and disease activity in rheumatoid arthritis (RA). The aim of this study was to compare Fgf23 levels in RA patients with a healthy population and to evaluate the relationship between Fgf23 levels in RA with disease activity, bone mineral density (BMD), and radiological damage score.
Results
The median Fgf23 levels in patients with RA and in hospital staff were 20.06 (11.2–51.0) and 26.40 (12.6–49.5) pg/ml (P < 0.001), respectively. RA patients were divided into active (DAS28 > 3.2) and inactive (DAS28 ≤ 3.2) subgroups. The median Fgf23 levels in active and inactive RA patients were 22.12 (13.90–51.02) and 17.71 (11.20–31.19) pg/ml, respectively (P = 0.001). BMD of RA patients was evaluated with dual-energy X-ray absorptiometry and radiological damage scores were evaluated independently by two investigators using the modified Sharp score (MSS). In RA patients, Fgf23 values correlated with DAS28 and with erosion score of observer-2 (r = 0.297, P = 0.036), but not with erosion score of observer-1 (r = 0.252, P = 0.077). No correlation was found between DAS28 and femur and lumbar vertebra BMD.
Conclusion
In RA, Fgf23 is not associated with BMD but may be associated with local bone loss and disease activity.
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Helgebostad R, Revheim ME, Johnsrud K, Amlie K, Alavi A, Connelly JP. Clinical Applications of Somatostatin Receptor (Agonist) PET Tracers beyond Neuroendocrine Tumors. Diagnostics (Basel) 2022; 12:diagnostics12020528. [PMID: 35204618 PMCID: PMC8870812 DOI: 10.3390/diagnostics12020528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 11/17/2022] Open
Abstract
Somatostatin receptor (SSTR) agonist tracers used in nuclear medicine scans are classically used for neuroendocrine tumor diagnosis and staging. SSTR are however, expressed more widely in a variety of cells as seen in the distribution of physiological tracer uptake during whole body scans. This provides opportunities for using these tracers for applications other than NETs and meningiomas. In this qualitative systematic review, novel diagnostics in SSTR-PET imaging are reviewed. A total of 70 studies comprised of 543 patients were qualitatively reviewed. Sarcoidosis, atherosclerosis and phosphaturic mesenchymal tumors represent the most studied applications currently with promising results. Other applications remain in progress where there are many case reports but a relative dearth of cohort studies. [18F]FDG PET provides the main comparative method in many cases but represents a well-established general PET technique that may be difficult to replace, without prospective clinical studies.
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Affiliation(s)
- Rasmus Helgebostad
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway; (R.H.); (M.-E.R.); (K.J.); (K.A.)
| | - Mona-Elisabeth Revheim
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway; (R.H.); (M.-E.R.); (K.J.); (K.A.)
- Institute of Clinical Medicine, University of Oslo, P.O. Box 1171 Blindern, 0318 Oslo, Norway
| | - Kjersti Johnsrud
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway; (R.H.); (M.-E.R.); (K.J.); (K.A.)
| | - Kristine Amlie
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway; (R.H.); (M.-E.R.); (K.J.); (K.A.)
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA;
| | - James Patrick Connelly
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway; (R.H.); (M.-E.R.); (K.J.); (K.A.)
- Correspondence:
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Revisiting the WHO classification system of soft tissue tumours: emphasis on advanced magnetic resonance imaging sequences. Part 1. Pol J Radiol 2020; 85:e396-e408. [PMID: 32999693 PMCID: PMC7509695 DOI: 10.5114/pjr.2020.98685] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 06/01/2020] [Indexed: 12/12/2022] Open
Abstract
The World Health Organisation (WHO) classification categorises musculoskeletal soft tissue tumours (STT) based on their similarity to normal adult tissue. The most recent WHO classification provides an updated scheme that integrates biological behaviour as a distinguishing feature in each subcategory; STTs are further subdivided as benign, intermediate (locally aggressive or rarely metastasising), and malignant. Although malignant STTs are infrequent in routine orthopaedic radiology practice, musculoskeletal radiologists must be familiar with the imaging appearance of malignant STTs and distinguish them from their benign counterparts for appropriate management. Magnetic resonance imaging (MRI) is the ideal modality for the detection, characterisation, and local staging of STT. This review will discuss the most recent updates to the WHO classification of STT that are relevant to radiologists in a routine clinical practice with MRI correlation. The utility of advanced MRI sequences such as diffusion weighted imaging, dynamic contrast enhanced sequences, and magnetic resonance spectroscopy to provide insight into the biological behaviour of various STTs is highlighted.
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