CHANGES IN THE METABOLISM OF CALCIUM AND PHOSPHORUS IN THE VARIOUS PHASES OF ACROMEGALY AND FOLLOWING THE IMPLANTATION OF THE PITUITARY GLAND WITH 90Y

ABSTRACT A study of calcium and phosphorus metabolism has been carried out on 13 acromegalic patients, in various stages of the disease. This study was repeated in nine patients following implantation of the pituitary gland with 90Y and in another two patients after deep X-ray therapy and suction removal of a pituitary adenoma respectively. Increased urinary calcium and phosphorus excretion was found in all the patients in whom the disease was in an active phase of evolution. The calcium tolerance test revealed a marked decrease of calcium retention in certain subjects, while in others, calcium retention was found to be increased. Such changes were not found in patients in whom the disease was in a quiescent phase. The blood calcium, phosphorus and alkaline phosphatase were found to be either normal or slightly increased. The implantation of the pituitary gland with 90Y and deep X-ray therapy induced a marked decrease of hypercalciuria, both spontaneous and induced, and of hyperphosphaturia, together with a definite improvement, of the clinical picture and glucose metabolism. It is concluded that the changes in calcium and phosphorus metabolism described above depend either directly or indirectly on a pituitary factor. They may therefore prove a reliable index for assessing pituitary growth hormone activity.