Review of pregnancy history may reveal polyhydramnios. Initially, patients with the infantile form of hypophosphatasia may appear normal until the onset of symptoms, which occurs when they are younger than 6 months. The infants have a history of poor feeding and failure to thrive. Hypotonia also has been reported. Patients with the childhood form often will have a history of delayed walking and early loss of deciduous teeth.
Bone pain is a frequent symptom.
The adult form usually presents during middle age. As with the childhood form, premature loss of deciduous teeth is common. Adults also may have a history of foot pain due to stress fractures and joint pain due to deposition of calcium pyrophosphate dihydrate. Odontohypophosphatasia presents with a premature loss of adult teeth. Infants with the lethal perinatal form may be stillborn.