scholarly journals Treatment of severe idiopathic hypoparathyroidism: a case report

2018 ◽  
Vol 21 (2) ◽  
pp. 36-40 ◽  
Author(s):  
Diliara Sh. Umiarova ◽  
Tatiana A. Grebennikova ◽  
Natalya V. Tarbaeva ◽  
Zhanna E. Belaya
Keyword(s):  
Vitamin D ◽  
Standard Treatment ◽  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Reference Interval ◽  
Ectopic Calcification ◽  
Therapeutic Tool ◽  
Autoimmune Destruction ◽  
Calcium Phosphorus ◽  
Bone Tissue Remodeling

Hypoparathyroidism is a rare disorder characterized by parathyroid hormone (PTH) insufficiency, the development of hypocalcemia and alteration of bone tissue remodeling. The goal of treatment is to normalize the indicators of calcium-phosphorus metabolism and leveling of clinical manifestations. Standard treatment of hypoparathyroidism consists of oral calcium and active forms of vitamin D, in doses necessary to maintain calcium levels at the lower limit of the reference interval. Nevertheless, treatment of the disease exerts certain difficulties in clinical practice. At the same time, compensation of the hypoparathyroidism is necessary to prevent ectopic calcification. Daily subcutaneous delivery of PTH (1–84) and PTH (1–34) has emerged as a promising therapeutic tool. However, its use should be restricted to patients insufficiently controlled with the standard treatment with active vitamin D and calcium. We present a clinical case of idiopathic hypoparathyroidism with severe clinical presentation of hypocalcaemia and ectopic calcification. Idiopathic hypoparathyroidism is a consequence of autoimmune destruction of the parathyroid glands and is exhibited by excluding all known causes of hypoparathyroidism. PTH (1–34) treatment allowed reducing the dose of calcium and vitamin D and achieving compensation of the disease.

scholarly journals Well-being, mood and calcium homeostasis in patients with hypoparathyroidism receiving standard treatment with calcium and vitamin D

2002 ◽  
pp. 215-222 ◽  
Author(s):  
W Arlt ◽  
C Fremerey ◽  
F Callies ◽  
M Reincke ◽  
P Schneider ◽  
...  
Keyword(s):  
Vitamin D ◽  
Standard Treatment ◽  
Treatment Options ◽  
Well Being ◽  
Controlled Study ◽  
Mineral Density ◽  
Current Standard ◽  
Cross Sectional ◽  
Calcium Phosphorus ◽  
The Impact

OBJECTIVE: Standard treatment in hypoparathyroidism consists of calcium and vitamin D (or vitamin D analogs) but does not employ replacement of the actual missing hormone. Only few studies have evaluated the efficacy of calcium/vitamin D treatment in hypoparathyroidism; the impact of chronic hypoparathyroid disease on well-being has not been investigated previously. DESIGN: Cross-sectional, controlled study in 25 unselected women with postsurgical hypoparathyroidism since 6.4plus minus8.0 years (s.d.) on stable treatment with calcium and vitamin D (or analogs) and in 25 controls with a history of thyroid surgery but intact parathyroid function, who were matched for sex, age and time since surgery. METHODS: Assessment of well-being and mood using validated questionnaires (the revised version Symptom Checklist 90 (SCL-90-R); the Giessen Complaint List (GBB-24); and the von Zerssen Symptom List (B-L Zerssen)), serum and urinary calcium/phosphorus homeostasis, and in the hypoparathyroid patients also screening for secondary disease by kidney ultrasound, ophthalmological split lamp examination, and measurement of bone mineral density. RESULTS: Serum calcium was in the accepted therapeutic range in the majority of hypoparathyroid patients. However, calcium/phosphorus homeostasis as a whole was clearly non-physiological. Nephrolithiasis was detected in 2 and cataracts in 11 of 25 hypoparathyroid patients. As compared with controls, hypoparathyroid patients had significantly higher global complaint scores in GBB-24 (P=0.036), B-L Zerssen (P=0.002) and SCL-90-R (P=0.020) with predominant increases in the subscale scores for anxiety, phobic anxiety and their physical equivalents. CONCLUSIONS: Current standard treatment in hypoparathyroidism is not only associated with an altered calcium/phosphorus homeostasis but also fails to restore well-being in these patients. Future studies need to address the impact of more physiological treatment options like parathyroid hormone(1-34) or parathyroid transplantation on well-being and mood in these patients.

scholarly journals MON-390 Vitamin D Metabolism in Patients with Acromegaly: A Case-Control Pilot Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Alexandra Povaliaeva ◽  
Ekaterina Pigarova ◽  
Artem Zhukov ◽  
Larisa Dzeranova ◽  
Victor Bogdanov ◽  
...  
Keyword(s):  
Vitamin D ◽  
Biochemical Parameters ◽  
Reference Interval ◽  
Control Group ◽  
Vitamin D Metabolites ◽  
Phosphorus Metabolism ◽  
Creatinine Ratio ◽  
Healthy Individuals ◽  
Blood Calcium ◽  
Calcium Phosphorus

Abstract Objective: to study the differences in the metabolism of vitamin D and calcium-phosphorus metabolism in patients with an active phase of acromegaly in comparison with healthy individuals. Materials and methods: The study included 8 patients with an active acromegaly, median age 36.5 ± 6.25 years, BMI 27.9 ± 1.95 kg/m2, IGF-1 907.3 ± 239 ng/ml, as well as 8 conditionally healthy individuals selected by age, sex and level of 25(OH)D determined by the immunochemiluminescent method (DEQAS certified). All participants were tested for calcium-phosphorus metabolism, PTH, and vitamin D metabolites by HPLC/MS-MS (25(OH)D3, 25(OH)D2, 3-epi-25(OH)D3 and 24,25(OH)2D3) before oral administration of 150 000 IU of an aqueous solution of cholecalciferol and 7 days after administration. Results: In the Acromegaly group, on the 7th day after taking the drug, there was a statistically significant increase in 25(OH)D3 (89.8 ± 10.5 vs. 54.1 ± 14.8 nmol/L), 3-epi-25(OH)D3 (9.0 ± 2.6 vs. 3.3± 1.1 nmol/L) and 24,25(OH)2D3 (8.3 ± 1.9 vs. 6.4 ± 2.1 nmol/L), and a decrease of 25(OH)D2 (0.8 ± 0.2 vs. 1.1 ± 0.3 nmol/L) and a ratio of 24,25(OH)2D3 to 25(OH)D3 (0.1 ± 0.02 vs. 0.13 ± 0.03). A statistically significant increase in albumin-adjusted calcium was also noted (2.39 ± 0.14 vs. 2.31 ± 0.13 mmol/L). The medians of the levels of PTH and phosphorus initially were 27.1 ± 13.5 pg/ml and 1.6 ± 0.3 mmol/l and did not change by day 7 after taking the drug; creatinine and magnesium levels also remained the same. The level of calcium-creatinine ratio in a single portion of urine (CCR) was initially within the reference interval for all patients, its median did not change by day 7, however, in two patients there was a clinically insignificant increase higher than the upper limit of the reference interval; the phosphorus-creatinine ratio in a single portion of urine increased significantly. In the control group, after taking cholecalciferol similar changes in the levels of the studied vitamin D metabolites were observed, the levels of PTH also remained the same, however, there were no changes in the median biochemical parameters of blood and urine by day 7 after drug intake. Among the studied vitamin D metabolites, there were initially no significant differences between the groups; on day 7 a difference was recorded for the level of 3-epi-25(OH)D3 (9.0 ± 2.6 in the Acromegaly group vs. 18.8 ± 8.9 nmol/L in the control group). Among the biochemical parameters in the Acromegaly group higher levels of ionized blood calcium (1.14 ± 0.05 vs 1.1 ± 0.03 mmol/L), blood phosphorus (1.61 ± 0.26 vs 1.15 ± 0.09 mmol/L) and CCR were observed. Conclusion: Loading dose of cholecalciferol in patients with acromegaly is associated with less production of 3-epi-25(OH)D3, and results in lower inactive fraction of vitamin D than in healthy controls. More studies are needed to evaluate the effect of 1.25(OH)2D3 level on calcium-phosphorus metabolism in acromegaly.

The Effects of Injected Vitamin D on Prognosis of Patients with Urosepsis

2018 ◽  
Vol 50 (05) ◽  
pp. 383-388
Author(s):  
Abolfazl Jokar ◽  
Koorosh Ahmadi ◽  
Ali Taherinia ◽  
Farshideh Didgar ◽  
Fatemeh Kazemi ◽  
...  
Keyword(s):  
Vitamin D ◽  
Uric Acid ◽  
Standard Treatment ◽  
Vital Signs ◽  
Control Group ◽  
Vitamin D Levels ◽  
Significant Difference ◽  
Calcium Phosphorus ◽  
The Difference ◽  
And Control

AbstractThe aim of this study was to evaluate the effect of prescribing vitamin D on improving the symptoms of patients diagnosed with urosepsis. The participants were randomly divided into two equal groups (each consisting of 50 patients). The patients in the first group received standard treatment with 300 000 units of injected vitamin with a volume of 1 cc. As for the patients in the second group, they received standard treatment along with 1 cc normal saline injected to them as placebo. Vital signs of the patients were checked every 6 h, while their CBC, EXR, CRP, creatinine, urea, and uric acid were checked 0, 24, 48, and 72 h following the interventions. Calcium, phosphorus, and vitamin D levels were measured 72 h following injection of the medicine. A significant difference was observed between the two groups in terms of the number of WBC’s in 24th, 48th, and 72nd hours. A similarly significant difference was reported between the case and control group in terms of the average BUN within 24th, 48th, and 72nd hours. The difference observed between the two groups in terms of average Cr within the 0th, 24th, 48th, and 72nd hours and in terms of days of hospitalization was also significant. Considering these results and keeping in mind the fact that no particular side effects were reported as a result of utilizing muscular injections of vitamin D and the easy and cheap use of this medicine, it can be used in auxiliary treatment of patients with urosepsis.

scholarly journals CLINICAL CASE OF TERIPARATIDE USE FOR THE TREATMENT OF POSTOPERATIVE HYPOPARATHYROIDISM WITH UNCONTROLLED HYPOCALCEMIA COMBINED WITH SEVERE OSTEOPOROSIS

2016 ◽  
Vol 19 (3) ◽  
pp. 37-40 ◽  
Author(s):  
T A Grebennikova ◽  
I I Larina ◽  
Zh E Belaya ◽  
L Y Rozhinskaya
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Surgical Procedures ◽  
Clinical Case ◽  
Standard Treatment ◽  
Clinical Presentation ◽  
Severe Osteoporosis ◽  
Oral Calcium ◽  
Postoperative Hypoparathyroidism ◽  
Severe Clinical Presentation

The development of postsurgical hypoparathyroidism is the most frequent complication of thyroidectomy and radical surgical procedures on the neck. Hypoparathyroidism is a disorder characterized by hypocalcemia, parathyroid hormone (PTH) deficiency, and abnormal bone remodeling. Standard treatment of hypoparathyroidism consists of oral calcium and active forms of vitamin D. However, some patients fail to achieve the normalization of calcium levels with this therapy. We present a clinical case of postsurgical hypoparathyroidism with severe clinical presentation of hypocalcaemia treated with recombinant human PTH 1-34 - teriparatide.

scholarly journals Maternal hypovitaminosis D: a cause of neonatal hypocalcemic seizures

2017 ◽  
Vol 4 (5) ◽  
pp. 1900
Author(s):  
G. Deepika ◽  
Chaitali R. Raghoji ◽  
Ashwini R. C. ◽  
G. Guruprasad
Keyword(s):  
Vitamin D ◽  
Late Onset ◽  
Clinical Manifestations ◽  
Distal Tubule ◽  
Hypovitaminosis D ◽  
Vitamin D Supplementation ◽  
The Body ◽  
Calcium Phosphorus ◽  
Calcium And Phosphorus ◽  
The One

Neonatal late onset hypocalcemia is the one which occurs after 72 hours of life. 1,25 (OH)2- vitamin D and Parathormone (PTH) play crucial role in regulation of calcium and phosphorus homeostasis in the body. Vitamin D helps in the absorption of calcium and phosphorus from the gut. PTH promotes absorption of calcium from thick ascending loop of henle and distal tubule whereas it increases excretion of phosphorus. During hypocalcemia, parathormone level shoot up in the body to maintain normal calcium levels. In a patient with poor resources of vitamin D, there is disturbance of Calcium, phosphorus homeostasis leading on to clinical manifestations. Exclusively breast-fed infants without vitamin D supplementation and infants born to mothers with Vitamin D deficiency are at risk to develop Hypovitaminosis D and manifest symptoms of hypocalcemia.

Status of Serum calcium, phosphorus and Vitamin D

2012 ◽  
Vol 2 (7) ◽  
pp. 329-330
Author(s):  
Saira Baloch ◽  
◽  
Bikha Ram Devrajani ◽  
Aneela Atta-ur-Rahman
Keyword(s):  
Vitamin D ◽  
Serum Calcium ◽  
Calcium Phosphorus

Vitamin D Provision in High-Yield Dairy Cows During the Winter Housing Period

2014 ◽  
Vol 1 (1) ◽  
pp. 42-46
Author(s):  
L. Yuskiv ◽  
V. Vlizlo
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase Level ◽  
Mineral Metabolism ◽  
Physiological State ◽  
Blood Parameters ◽  
Postnatal Period ◽  
High Yield ◽  
Oral Supplementation ◽  
Calcium Phosphorus ◽  
Vitamin D 3

Aim. To investigate the vitamin D status in highly productive cows during winter housing period and effect of cholecalciferol by various ways of vitamin D 3 injection to cows in last days of gestation and after calving. Methods. Enzyme-linked immunoassay, spectrophotometry. Results. It has been stated that intramuscular injection of cholecalciferol into cows caused increase of the vitamin D 3 active metabolite – 25-OHD 3 , calcium, phosphorus and magnesium levels together with decrease of alkaline phosphatase level in pre- and post-natal periods. Oral supplementation makes little infl uence on the studied blood parameters of cows. Conclusions. Extrabuccal administration and oral supplementation of cholecalciferol in winter housing period to high-yield cows in the last days of gestation and after calving is accompanied by increased levels of its metabolites and their effect on mineral metabolism in the postnatal period. The nature of these changes depends on the mode of vitamin D administration and the physiological state of the cows.

scholarly journals Disruption of Abcc6 Transporter in Zebrafish Causes Ocular Calcification and Cardiac Fibrosis

2020 ◽  
Vol 22 (1) ◽  
pp. 278
Author(s):  
Jianjian Sun ◽  
Peilu She ◽  
Xu Liu ◽  
Bangjun Gao ◽  
Daqin Jin ◽  
...  
Keyword(s):  
Vitamin K ◽  
Cardiac Fibrosis ◽  
Clinical Manifestations ◽  
Pseudoxanthoma Elasticum ◽  
Matrix Gla Protein ◽  
Ectopic Calcification ◽  
Transcription Activator ◽  
Multisystem Disorder ◽  
Ectopic Mineralization ◽  
Extensive Calcification

Pseudoxanthoma elasticum (PXE), caused by ABCC6/MRP6 mutation, is a heritable multisystem disorder in humans. The progressive clinical manifestations of PXE are accompanied by ectopic mineralization in various connective tissues. However, the pathomechanisms underlying the PXE multisystem disorder remains obscure, and effective treatment is currently available. In this study, we generated zebrafish abcc6a mutants using the transcription activator-like effector nuclease (TALEN) technique. In young adult zebrafish, abcc6a is expressed in the eyes, heart, intestine, and other tissues. abcc6a mutants exhibit extensive calcification in the ocular sclera and Bruch’s membrane, recapitulating part of the PXE manifestations. Mutations in abcc6a upregulate extracellular matrix (ECM) genes, leading to fibrotic heart with reduced cardiomyocyte number. We found that abcc6a mutation reduced levels of both vitamin K and pyrophosphate (PPi) in the serum and diverse tissues. Vitamin K administration increased the gamma-glutamyl carboxylated form of matrix gla protein (cMGP), alleviating ectopic calcification and fibrosis in vertebrae, eyes, and hearts. Our findings contribute to a comprehensive understanding of PXE pathophysiology from zebrafish models.

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