scholarly journals A patient with extensive cerebral calcification due to pseudohypoparathyroidism: a case report

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
S. W. De Silva ◽  
S. D. N. De Silva ◽  
C. E. De Silva
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Muscle Power ◽  
Acute Onset ◽  
Biochemical Response ◽  
Cerebral Calcifications ◽  
Parenteral Infusions ◽  
25 Hydroxy Vitamin D ◽  
History Of ◽  
First Time

Abstract Background Pseudohypoparathyroidism(PHP) is a heterogeneous group of disorders due to impaired activation of c AMP dependant pathways following binding of parathyroid hormone (PTH) to its receptor. In PHP end organ resistance to PTH results in hypocalcaemia, hyperphosphataemia and high PTH levels. Case presentation A 59 year old male presented with a history of progressive impairment of speech and unsteadiness of gait for 1 week and acute onset altered behavior for 1 day and one episode of generalized seizure. His muscle power was grade four according to MRC (medical research council) scale in all limbs and Chovstek’s and Trousseau’s signs were positive. Urgent non contrast computed tomography scan of the brain revealed extensive bilateral cerebral and cerebellar calcifications. A markedly low ionized calcium level of 0.5 mmol/l, an elevated phosphate level of 9.5 mg/dl (reference range: 2.7–4.5 mg/dl) and an elevated intact PTH of 76.3 pg/l were noted. His renal functions were normal. His hypocalcemia was accentuated by the presence of hypomagnesaemia. His 25 hydroxy vitamin D level was only marginally low which could not account for severe hypocalcaemia. A diagnosis of pseudohypoparathyroidism without phenotypic defects, was made due to hypocalcaemia and increased parathyroid hormone levels with cerebral calcifications. The patient was treated initially with parenteral calcium which was later converted to oral calcium supplements. His coexisting Vitamin D deficiency was corrected with 1αcholecalciferol escalating doses. His hypomagnesaemia was corrected with magnesium sulphate parenteral infusions initially and later with oral preparations. With treatment there was a significant clinical and biochemical response. Conclusion Pseudohypoparathyroidism can present for the first time in elderly resulting in extensive cerebral calcifications. Identification and early correction of the deficit will result in both symptomatic and biochemical response.

scholarly journals Parathyroid Hormone in Pregnancy: Vitamin D and Other Determinants

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 360
Author(s):  
Ola Hysaj ◽  
Patricia Marqués-Gallego ◽  
Aline Richard ◽  
Magdeldin Elgizouli ◽  
Alexandra Nieters ◽  
...  
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Inflection Point ◽  
Demographic Data ◽  
Late Pregnancy ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
25 Hydroxy Vitamin D ◽  
Maximal Suppression

We aimed to assess the parathyroid hormone (PTH) concentration in pregnant women at the beginning of pregnancy (1st trimester) and within days before delivery (3rd trimester) and evaluate its determinants. From September 2014 through December 2015 in a cross-sectional study, 204 women in the 1st trimester of pregnancy and 203 women in the 3rd trimester of pregnancy were recruited. Blood samples were collected to measure PTH and circulating 25-hydroxy-vitamin D (25(OH)D) concentrations. Lifestyle and demographic data were collected using a questionnaire. Serum 25(OH)D and PTH were inversely correlated in both early and late pregnancy. Our analyses suggest that in the 3rd trimester of pregnancy, a 25(OH)D level of 18.9 ng/mL (47.3 nmol/L) could serve as an inflection point for the maximal suppression of PTH. Statistically significant determinants of PTH concentrations in multiple regression were 25(OH)D concentrations, season, multiparity and education of the partner (all p < 0.05) in early pregnancy. In late pregnancy, 25(OH)D concentrations and country of origin were statistically significant determinants of PTH concentrations (all p < 0.05). These factors and their effect on PTH appear to be vastly determined by 25(OH)D; however, they might also affect PTH through other mechanisms besides 25(OH)D.

scholarly journals Suboptimal Serum 25-Hydroxy-Vitamin D Is Associated with a History of Recent Disease Exacerbation in Pediatric Patients with Bronchial Asthma or Asthma-Suggestive Recurrent Wheezing

2020 ◽  
Vol 17 (18) ◽  
pp. 6545
Author(s):  
Teodora-Irina Adam-Bonci ◽  
Paraschiva Cherecheș-Panța ◽  
Eduard-Alexandru Bonci ◽  
Sorin Claudiu Man ◽  
Ancuța Cutaș-Benedec ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D3 ◽  
Pediatric Asthma ◽  
Asthma Severity ◽  
Cross Sectional Study ◽  
Disease Exacerbation ◽  
Recurrent Wheezing ◽  
Cross Sectional ◽  
25 Hydroxy Vitamin D ◽  
History Of

Even though vitamin D is widely acknowledged as having a potential immunomodulatory role in asthma, its exact beneficial mechanisms are yet to be clarified. An optimal serum 25-hydroxy-vitamin D (25-OH-VitD) level in pediatric asthma patients might not rely solely on the effect of dose-dependent vitamin D3 intake, but might also be influenced by factors related to insufficient asthma control. We aimed to survey the prevalence of serum 25-OH-VitD deficiency and analyze whether suboptimal levels were associated with asthma severity factors. The current cross-sectional study enrolled 131 pediatric asthma or asthma-suggestive recurrent wheezing patients, for whom serum 25-OH-VitD, IgE, and eosinophil count were assessed. The prevalence of suboptimal serum 25-OH-VitD was 58.8%. A suboptimal vitamin D status was associated with asthma exacerbation in the previous month (p = 0.02). Even under seasonal oral vitamin D3 supplementation, patients with a positive history of asthma attack in the previous four weeks presented significantly lower serum 25-OH-VitD concentrations, compared to their peers with no disease exacerbation. In conclusion, sequential measurements of serum 25-OH-VitD might prove useful for future studies evaluating the dynamic changes in vitamin D3 status in regard to asthma, especially in symptomatic patients.

scholarly journals Falsely Elevated 25-Hydroxy-Vitamin D Levels in Patients with Hypercalcemia

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Moon Kyung Choi ◽  
Prapaipan Putthapiban ◽  
Patamaporn Lekprasert
Keyword(s):  
Multiple Myeloma ◽  
Vitamin D ◽  
Parathyroid Hormone ◽  
Diagnostic Workup ◽  
Laboratory Measurement ◽  
Clinical Scenario ◽  
Detailed History ◽  
Commercial Laboratory ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D

Symptomatic hypercalcemia is a commonly encountered clinical scenario. Though it is important to collect detailed history to find clinical clues connecting to the etiology of hypercalcemia, the diagnostic workup of hypercalcemia depends heavily on laboratory analysis. Accurate measurement of the parathyroid hormone and vitamin D levels is essential. However, commercial laboratory measurement of vitamin D levels can be erroneous in the setting of abundant paraprotein in the serum. One of the most common conditions that can cause an increased amount of paraproteins is multiple myeloma. We report 2 cases of falsely elevated 25-hydroxy-vitamin D levels in patients presenting with hypercalcemia and an underlying diagnosis of MM.

Serum 25 – hydroxy – vitamin D and parathyroid hormone in adult inhabitans of Lapland

1983 ◽  
Vol 104 (3_Supplc) ◽  
pp. S23-S24
Author(s):  
C. Lamberg–Allardt ◽  
A. Dessypris ◽  
B.A. Lamberg
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
25 Hydroxy Vitamin D

scholarly journals Association between serum vitamin B6concentration and risk of osteoporosis in the middle-aged and older people in China: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e028129 ◽  
Author(s):  
Jing Wang ◽  
Lin Chen ◽  
Yan Zhang ◽  
Chen-guang Li ◽  
Hao Zhang ◽  
...  
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Type I Collagen ◽  
Bone Turnover Marker ◽  
Serum Vitamin ◽  
Type I ◽  
Hormone Concentration ◽  
Mineral Density ◽  
Cross Sectional ◽  
25 Hydroxy Vitamin D

ObjectiveTo determine the relationship between serum vitamin B6(Vit B6) concentration and the status of bone mineral density and identify the relationship between serum Vit B6 and bone metabolism parameters in middle-aged and older people in China.DesignThe present study was a cross-sectional study within the framework of an ongoing prospective population-based cohort study.Setting and participantsA total of 1829 residents (men ≥50 years and women ≥45 years) from two subdistricts were recruited from July 2015 to February 2016 in Shanghai, China.MeasuresRecruited residents were grouped (control, osteopenia and osteoporosis) according to their lumbar spine bone mineral density, measured through dual-energy X-ray absorptiometry. Serum Vit B6concentrations, bone turnover marker concentrations and calcium and phosphorus metabolism parameters were assessed.ResultsNo significant linear trend between serum Vit B6concentrations and lumbar bone mass was observed in the men. In the women, the average osteoporosis risk was 61% higher at serum Vit B6concentrations of <19.2 μg/L than at those of >26.9 μg/L (OR 1.61, 95% CI 1.00 to 2.58). However, there was no significance after controlling of serum 25-hydroxy-vitamin D concentration and parathyroid hormone concentration, respectively. In the osteoporotic women, the serum Vit B6concentration was significantly negatively correlated to concentrations of bone turnover marker including N-terminal propeptide of type I collagen, β-C-terminal telopeptide of type I collagen and osteocalcin. It was also positively related to the serum 25-hydroxy-vitamin D concentration and inversely related to the serum parathyroid hormone concentration.ConclusionsA relatively low serum Vit B6concentration, even in the normal range, may be a risk factor for osteoporosis in postmenopausal women, which is dependent on serum 25-hydroxy-vitamin D concentration and parathyroid hormone concentration.Trial registration numberNCT02958020; Post-results.

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