Abstract |
In order to clarify the complex interrelationship between serum calcium, 1,25-dihydroxyvitamin D (1,25( OH)2D), and parathyroid hormone (PTH), and the urinary excretion of cyclic AMP (cAMP) in response to exogenous PTH in pseudohypoparathyroidism (PHP) and related diseases, we investigated 3 patients with parathyroid disorders before and after treatment with 1 alpha-hydroxyvitamin D3 (1 alpha-OH-D3). Low plasma 1,25( OH)2D before treatment increased after giving 1 alpha-OH-D3 (0.1 micrograms/kg/day), whereas high plasma PTH measured by the c-terminal assay (C-PTH) decreased in all 3. No response in urinary cAMP was found before or after treatment in 2 patients with PHP type I, despite the fall of plasma C-PTH. However, in one patient with extremely high plasma C-PTH but normal N-PTH (measured by a homologous radioimmunoassay using 1-34 human PTH), urinary cAMP response to exogenous PTH was increased after treatment with 1 alpha-OH-D3. We suggest that he had pseudopseudohypoparathyroidism ( PPHP) with Albright's hereditary osteodystrophy and a partial deficiency of renal 1 alpha- hydroxylase. In this patient secondary hyperparathyroidism is thought to be due to 1,25( OH)2D deficiency, and the decreased responsiveness to exogenous PTH before treatment due to excess PTH occupying renal receptors.
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Authors | Y Seino, M Ishida, K Yamaoka, T Shimotsuji, T Ishii, H Yabuuchi, M Fukase, T Fujita |
Journal | European journal of pediatrics
(Eur J Pediatr)
Vol. 135
Issue 3
Pg. 267-71
(Feb 1981)
ISSN: 0340-6199 [Print] Germany |
PMID | 6262082
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Dihydroxycholecalciferols
- Hydroxycholecalciferols
- Parathyroid Hormone
- Cyclic AMP
- Calcium
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Topics |
- Adolescent
- Calcium
(blood)
- Child
- Child, Preschool
- Cyclic AMP
(urine)
- Dihydroxycholecalciferols
(blood)
- Female
- Humans
- Hydroxycholecalciferols
(blood)
- Hyperparathyroidism, Secondary
(complications)
- Male
- Parathyroid Hormone
(blood)
- Pseudohypoparathyroidism
(complications)
- Vitamin D Deficiency
(complications)
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