Question: A 45-year-old man with a 22-year history of Crohn’s disease was admitted for muscular weakness, and bilateral groin and shoulder pain. On examination the patient presented with waddling walk, proximal muscular weakness, and a positive Gower’s sign. Laboratory tests showed anemia with a hemoglobin concentration of 8.2 g/dL. He presented with mild hypocalcemia and severe hypophosphatemia (0.46 mmol/L) with increased urinary excretion of phosphate (fractional excretion of phosphate, 46%).