204 



J.-F. Dymling 



she presented a clinical picture of severe renal tubular osteomalacia. After a detailed 

 study treatment was started with sodium monophosphate 8 Gm daily. After another 

 study vitamin D, was given in addition. The dosages were settled at 6 Gm sodium 

 monophosphate and 675.000 I.U. vitamin Do . 



Case J. C. Male, born in 1908. Family history not possible to trace. Skeletal 

 symptoms were first noted at the age of 25. Admitted to several hospitals, and given 

 a tentative diagnosis of Albright's disease. No treatment before admission to Malmo 

 General Hospital in 1963. At that time he presented a clinical picture of moderately 

 severe renal tubular osteomalacia. After an initial study with ^^Sr, he refused treat- 

 ment, but later he changed his mind and a second study in the untreated state was 

 performed using ■^"Ca. Treatment was started with sodium monophosphate, 10 Gm 

 daily. After another study vitamin Do was given in addition. The dosages were 

 settled at 10 Gm of sodium monophosphate and 65.000 I.U. of vitamin Do . 



Methods 



The kinetic studies were performed with 

 (1964). 



Results 



The results are found in Tables 1 and 2 and Fi 

 Case T. C. During treatment 



"■Ca or ^■'^Sr according to Dymling 



Treated 



there was a slight increase In serum calcium and 

 urine calcium. There was no change in serum phos- 

 phate but a striking increase In urine phosphate. 

 After seven months of treatment there was an 

 Increase of the accretion rate, which returned to 

 the orglnal level after two years of treatment. 

 Radiographically there appeared healing of the 

 pseudofractures and calcification of vertebral 

 osteophytes. The clinical improvement was dra- 

 matic and he resumed work as a painter. 



Case M. B. During treatment there were no 

 changes in serum or urine calcium. The serum 

 phosphate rose as did the urine phosphate. The 

 level of alkaline phosphatase decreased. The ac- 

 cretion rate increased on oral supplements of phos- 

 phate, and increased further on phosphate supple- 

 ments plus vitamin D. Having reached a peak 

 value the accretion rate slowly returned to the 

 original value two years after treatment was 

 started. The exchangeable compartment Sn re- 

 mained unchanged during the first six months of 

 treatment but tended to decrease thereafter. Radio- 

 graphically an increased mineral content was 

 established after two and a half years of treat- 

 ment. The clinical improvement was very dramatic and she has for the first time in 

 her life been able to work and to take part In out-door life. 



Fig. 1. Kl 



li 8 1 8 12 W202t26 

 data in three cases of renal 



