Case Discussion VDRR2 28.07.1399

• A 14 y/o boy :
  - known case of VDDR 2
  - Delay in teething
  - Delay in walking
  - Seizure in the age of 12 months
  - Bowing of lower limbs
  - Lack of bone change
  - Radiological findings are currently normal
  - Progressive Alopecia from the age of 12 months
  - Hyperphosphatemia, Hypocalcemia
  - High ALP, high PTH , normal low 25(OH)D Diagnostic approach to VDDR 2 ?
• What is the cause of hyperphosphatemia in this patient ?
• What is the reason for the lack of bone change in this patient ?
• What is the effect of the onset of puberty in this disease ?
• What is the cause and treatment of alopecia in this patient ?
• What is the treatment of this patient ?