Phosphate diabetes has been considered as rare and to occur almost exclusively in children. Upon examination of adult patients with rheumatic or
kidney diseases it has, however, been found that the combination of hypophosphataemia and
hyperphosphaturia is not so rare. This paper deals with 24 adult patients of this type, whom we have found during 6 months. Their mean serum
phosphorus concentration was 0.7 mmol/l (range 0.5--0.8). Mean
phosphate clearance was 31 ml/min/1.73 m2 (range 16--51). The diagnoses were
myalgia, dorsalgia (n = 7),
papillitis calcificans (n = 5),
prostatitis or prostate accretions (n = 4),
dizziness (n = 2),
kidney stones, tubular defect,
interstitial nephritis,
medullary sponge kidney (1 case each), two patients had transplanted kidneys.
Asthenia was a common additional diagnosis. The patients' complaints have been
pain in the muscles, joints, bones (18 cases), tiredness (10 cases),
dizziness (8 cases), shakyness,
numbness, burning sensation (7 cases), tenderness in the muscles and bones ("the princess-on-the-pea syndrome") (7 cases). The most common findings upon examination were bone tenderness (13 cases), reduced manual power (8 cases), positive Romberg test (3 cases), slight
muscle atrophy (2 cases), waddling gait (2 cases). The most common findings encountered in the laboratory, besides hypophosphataemia and
hyperphosphaturia, were high pH in the urine, hyperaminoaciduria, and
phosphate crystals in dried urine.