Rickets
ICD-10 E55.0 · ICD-11 5B57.0

Treatment of Rickets in Fibrous Dysplasia and McCune-Albright Syndrome

This protocol addresses hypophosphatemic rickets arising from renal phosphate wasting in patients with fibrous dysplasia caused by an activating GNAS gene mutation — the hallmark of McCune-Albright syndrome.

Fibrous dysplasia driven by activating GNAS mutations (McCune-Albright syndrome) can lead to hypophosphatemic rickets through renal phosphate wasting. Management of this population primarily addresses non-rickets complications of fibrous dysplasia, but the rickets component requires specific treatment when present.

An established initial approach involves oral phosphate supplementation combined with an active vitamin D analogue; the full protocol specifies when and how to escalate beyond this first-line strategy.

  • Normalisation of serum phosphate
  • Normalisation of serum alkaline phosphatase
  • Improvement of bone pain
  • Improvement of muscle weakness
  • Improvement of walking ability
References

DOI: 10.1007/s00467-022-05505-5

Treatment of patients with fibrous dysplasia (FD), which is due to activating mutations in the GNAS gene causing McCune-Albright syndrome primarily focuses on non-rickets complications.

Treatment with phosphate salts and active vitamin D may be considered in patients presenting with hypophosphatemic rickets due to renal phosphate wasting.

View source ↗