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Chronic idiopathic hyperphosphatasia(CIH) or juvenile Paget disease is believed to be a distinct disease characterized
by an increase in the serum alkaline phosphatase, cortical thickening and bowing of the long bones, especially
the femora. It is a rare autosomal recessive bone disorder, with excessive bone resorption and bone formation.
Skeletal malformations in the legs may cause problems in walking and may eventually result in short stature. The
radiographic appearances include widening of the diaphyses, vertebral osteoporosis, acetabular protrusion, and
thickening of the skull vault. Intensive bisphosphonate treatment prevented the development of deformity and disability
but there is no published data on long-term efficacy. Bisphosphonate therapy showed suppression of bone
turnover, doubling of trabecular thickness with no mineralization defect, and no osteopetrosis. We report a female
of 21 years, a case of chronic idiopathic hyperphosphatasia congenital form, with a history of fracture, short stature
and malformed teeth. She had a waddling gait, bone deformities, kyphoscoliosis and curvature of her limbs.
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