Hereditary X-Linked Hypophosphatemia and Thoracic Myelopathy

Abstract

Objective: To present a serious complication of X-linked hereditary hypophosphatemia. Methods: The authors present the case of a 49-year-old man who presented to the hospital with back pain and was found to have a thoracic myelopathy caused by hypertrophy of the ligamentum flavum. Results: The treating physicians found that the patient had calcification and hypertrophy of the ligamentum flavum that compressed the thoracic spinal cord and caused incomplete paraplegia. The patient's symptoms improved with decompression of the spinal cord. Conclusion: Patients with X-linked hereditary hypophosphatemia are at risk for compression of the spinal cord. Patients with this syndrome who present with back pain need to be examined carefully for evidence of spinal cord compression. Abbreviations: FGF23 = fibroblast growth factor 23 PTH = parathyroid hormone XLH = X-linked hypophosphatemia