Abstract
X-linked hypophosphatemic rickets (XLH) is a rare disorder, with a global incidence of approximately 3.9–5 cases per 100,000 live births and a prevalence of approximately 1.7 cases per 100,000 children (4). Considerable variability in genotype and phenotype expression is a hallmark of XLH. This variability significantly limits the definition of a single, standardized “typical case,” as variable expressivity results in a broad spectrum of clinical manifestations that differ in severity and symptomatology. Furthermore, this complexity is compounded by the identification of more than 300 pathogenic variants in the PHEX gene.
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