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At a glance

This is a medical condition characterized by osteofibrosis due to low concentration of phosphorus. Clinically, affected patients present with pathological fractures. It is considered an electrolyte disturbance, especially involving calcium and phosphate.

N.B.: This is not to be confounded with Miller’s Syndrome that is characterized by Postaxial Acrofacial Dysostosis.


Calciferol Osteomalacia; Idiopathic Pseudofracture; Looser Syndrome; Looser Zones; Looser-Debray-Milkman Syndrome; Osteoporosis-Osteomalacia Syndrome.


The exact incidence remains unknown. The literature refers to a pathological condition seen in horses.

Genetic inheritance

There is no genetic association. It is a metabolic disease.

Clinical aspects

It is a very old name for severe vitamin D deficiency. This can lead to decreased intestinal absorption of calcium and secondary hyperparathyroidism.

Anesthetic considerations

The electrolytes should be carefully measured, especially calcium and phosphate, and corrected before anesthesia. Careful positioning of the osteopenic patient is necessary to prevent pathologic bone fractures. There is no evidence that a specific anesthetic drug or technique has advantages over any other. The response to the neuromuscular blocking drugs may be unpredictable.


Barash  PG, Cullen  BF, Stoelting  RK: Clinical Anesthesia. Philadelphia, Lippincott Williams & Wilkins, 2001.

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