Calcium Deficiency Rickets in African Adolescents: Cortical Bone Histomorphometry

The diagnosis in a 1-year-old female with skeletal and chemical rickets, generalized hyperaminoaciduria, and metabolic acidosis was uncertain, and primary renal disease (i.e., Fanconi "syndrome") was considered. She had been on a diet which was deficient in calcium (approximately 21 to 36 mg calcium daily) but adequate for phosphorus and vitamin D. Her skeletal and renal lesions resolved within 3 months on a high calcium diet. Early in her hospital course, an intravenous calcium infusion provided 10 mg/kg calcium, as calcium gluconate over 3 hours; 8 to 10 hours later, a significant reduction in urinary amino acids and phosphorus was observed. The mechanism through which this response was mediated is postulated to be via reduction in circulating parathormone.

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Calcium-deficiency rickets in a four-year-old boywith milk allergy

The Journal of Pediatrics ◽

10.1016/s0022-3476(06)80124-1 ◽

1993 ◽

Vol 122 (2) ◽

pp. 249-251 ◽

Cited By ~ 30

Author(s):

M. Davidovits ◽

Y. Levy ◽

T. Avramovitz ◽

B. Eisenstein

Keyword(s):

Calcium Deficiency ◽

Milk Allergy ◽

Deficiency Rickets

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Sweep imaging with Fourier transform as a tool with MRI for evaluating the effect of teriparatide on cortical bone formation in an ovariectomized rat model

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04970-7 ◽

2022 ◽

Vol 23 (1) ◽

Author(s):

Yasutaka Sotozono ◽

Kazuya Ikoma ◽

Masamitsu Kido ◽

Okihiro Onishi ◽

Masataka Minami ◽

...

Keyword(s):

Fourier Transform ◽

Bone Formation ◽

Cortical Bone ◽

Bone Histomorphometry ◽

Signal To Noise Ratio ◽

Formation Rate ◽

Bound Water ◽

Proton Density ◽

Sprague Dawley ◽

Bone Formation Rate

Abstract Background Teriparatide (TPTD) is a drug for osteoporosis that promotes bone formation and improves bone quality. However, the effects of TPTD on cortical bone are not well understood. Sweep imaging with Fourier transform (SWIFT) has been reported as a useful tool for evaluating bound water of cortical bone, but it has yet to be used to investigate the effects of TPTD on cortical bone. This study aimed to evaluate the consequences of the effect of TPTD on cortical bone formation using SWIFT. Methods Twelve-week-old female Sprague-Dawley rats (n = 36) were reared after ovariectomy to create a postmenopausal osteoporosis model. They were divided into two groups: the TPTD and non-TPTD groups. Rats were euthanized at 4, 12, and 24 weeks after initiating TPTD treatment. Tibial bones were evaluated using magnetic resonance imaging (MRI) and bone histomorphometry. In MRI, proton density-weighted imaging (PDWI) and SWIFT imaging were performed. The signal-to-noise ratio (SNR) was calculated for each method. The same area evaluated by MRI was then used to calculate the bone formation rate by bone histomorphometry. Measurements were compared using the Mann-Whitney U-test, and a P-value of < 0.05 was considered significant. Results PDWI-SNR was not significantly different between the two groups at any time point (P = 0.589, 0.394, and 0.394 at 4, 12, and 24 weeks, respectively). Contrarily, SWIFT-SNR was significantly higher in the TPTD group than in the non-TPTD group at 4 weeks after initiating treatment, but it was not significantly different at 12 and 24 weeks (P = 0.009, 0.937, and 0.818 at 4, 12, and 24 weeks, respectively). The bone formation rate assessed by histomorphometry was significantly higher in the TPTD group than in the non-TPTD group at all timepoints (P < 0.05, all weeks). In particular, at 4 weeks, the bone formation rate was markedly higher in the TPTD group than in the non-TPTD group (P = 0.028, 1.98 ± 0.33 vs. 0.09 ± 0.05 μm3/μm2/day). Conclusions SWIFT could detect increased signals of bound water, reflecting the effect of TPTD on the cortical bone. The signal detected by SWIFT reflects a marked increase in the cortical bone formation rate.

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CALCIUM DEFICIENCY REDUCES CORTICAL BONE ASH WEIGHT BUT NOT STRAIN RESPONSE TO LOADING 576

Medicine & Science in Sports & Exercise ◽

10.1097/00005768-199705001-00575 ◽

1997 ◽

Vol 29 (Supplement) ◽

pp. 99

Author(s):

X. Wu ◽

S. Bloomfield

Keyword(s):

Cortical Bone ◽

Calcium Deficiency ◽

Strain Response ◽

Bone Ash ◽

Ash Weight

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Severe Renal Osteodystrophy Without Elevated Serum Immunoreactive Parathyroid Hormone Concentrations in Hypomagnesemia Due to Renal Magnesium Wasting

PEDIATRICS ◽

10.1542/peds.79.3.403 ◽

1987 ◽

Vol 79 (3) ◽

pp. 403-409

Author(s):

Israel Zelikovic ◽

Shermine Dabbagh ◽

Aaron L. Friedman ◽

Mark L. Goelzer ◽

Russell W. Chesney

Keyword(s):

Renal Failure ◽

Parathyroid Hormone ◽

Elevated Serum ◽

Fractional Excretion ◽

Calcium Deficiency ◽

Deficiency Rickets ◽

Renal Magnesium Wasting ◽

Magnesium Excretion ◽

Moderate Renal Failure ◽

Immunoreactive Parathyroid Hormone

An 8½-year-old girl presented with a long history of seizures, growth retardation, muscle weakness, gait disturbance, and hearing loss. Her evaluation revealed chronic moderate renal failure (serum creatinine 2.2 mg/dL), severe hypocalcemia (5 mg/dL), hyperphosphatemia (8.1 mg/dL), hypomagnesemia (1.5 mg/dL), increased urinary magnesium excretion (2 mg/kg/d), high fractional excretion of magnesium (21.7%), hypokalemia (3.2 mEq/L), and hyperkaliuria (26 mEq/L). Low circulating immunoreactive parathyroid hormone levels for the degree of the hypocalcemia (serum N-parathyroid hormone 212 pg/mL) and severe rickets without evidence of osteitis fibrosa cystica were found. The patient probably has primary renal leak hypomagnesemia (magnesuric hypomagnesemia) which caused impaired secretion of immunoreactive parathyroid hormone leading to severe hypocalcemia and calcium deficiency rickets. Treatment with magnesium and calcium supplements, calcitriol, and aluminum hydroxide resulted in marked clinical, biochemical, and radiologic improvement. Calcium deficiency rickets due to primary or secondary renal magnesium wasting in conjunction with moderate renal failure represents a largely unrecognized metabolic bone disease.

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