Multiple pathological fractures in acquired Fanconi's syndrome after treatment of psoriasis with fumaric acid

We report about a rare case of a pathological fracture of the shank followi ng earlier pathological fractures at other locations in a comparatively you ng female patient with no history of trauma. There were no known diseases o ther than psoriasis. The shank fracture was treated surgically by osteosynthesis. Osteoporosis, myeloma, or malignancy as causative factors of this fracture could be exclu ded. Scintigraphy showed an enhancement, especially at the extremities. Oth er than reactive bone growth, histological examination revealed no further aspects. Laboratory analysis indicated a massive lack of Vitamin D-3 After transferring the patient to the internal department of our hospital,long-te rm medication with fumaric acid was determined to be the reason for the ost eomalacia of a Fanconi's syndrome. Three months after cessation of these medicaments and treatment with active vitamin D-3 metabolites, the patient was free of complaints. The radiograp hs showed an essential improvement of the demineralization.