A 29-year-old man has progressive bone pain, proximal weakness and two atraumatic metatarsal fractures. Serum phosphate is 0.44 mmol/L (0.80–1.50), calcium is 2.34 mmol/L (2.15–2.55), alkaline phosphatase is 260 U/L (30–110), and 25-hydroxyvitamin D is 78 nmol/L (greater than 50). Urinary studies show inappropriate phosphate wasting, and fibroblast growth factor 23 is markedly elevated. Which diagnosis is most likely?

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