tive findings were noted except knocking pain of the sternum. ribs, and lumbar vertebrae. LabordtOry tests showed mild normochromic anemia (Hb 10.5 gldl). The alkaline phosphatase (ALP) was high (977 IU/liter) and the serum phosphate level as low (1.4 mg/dl). Serum iron was high (168 pgidl), and ferritin was abnormally high (4,050 ng/dl). The parathyroid hormone was normal. TRP was low at 72.5%. Technetium-99 bone scintigraphy showed abnormal uptake around the shoulders, ribs, hips, and ankles. After admission, the SFO, which had been administered for about 1year, was withdrawn, and milk was given to improve her hypophosphatemia. The phosphate level increased to a normal range in 3 weeks.Bone pain, ferritin. and ALP levels also gradually improved.Since the first report [ I ] , eight cases including our case have been reported of osteomalacia caused by SFO ( Table I). There were five patients with iron deficiency anemia (may be misdiagnosis). In all of these patients. bone pain appeared 3 4 months after starting the administration of SFO, and dysbasia was observed. The bone pain improved after withdrawal of SFO in all cases. Hypophosphatemia, abnormal uptake of phosphate in the renal tubules, and high ferritin and ALP levels were commonly observed.Also, improvement of these abnormalities after withdrawal of SFO was also observed. Although bone biopsy was not performed in our case, it was performed in three of the eight patients and a definite diagnosis of osteoma-
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