Extracellular cyclic AMP levels in osteomalacia

1980 ◽  
Vol 95 (2) ◽  
pp. 282-288 ◽  
Author(s):  
Jose A. Sisson de Castro ◽  
Joseph R. Tucci
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Cyclic Amp ◽  
Serum Calcium ◽  
Serum Electrolytes ◽  
Calcium Phosphorus ◽  
Calcium Infusion ◽  
Appropriate Therapy ◽  
Urinary Cyclic Amp ◽  
Normal Increase

Abstract. Plasma and urinary cyclic AMP were measured in a 62-year-old man with severe osteomalacia due to a gluten-induced enteropathy. Before therapy, plasma cyclic AMP was normal and both urinary and nephrogenous cyclic AMP were markedly increased. A calcium infusion acutely diminished the elevated iPTH and urinary cyclic AMP levels. Following a bolus infusion of PTE, there was no phosphaturia despite a somewhat exaggerated increase in cyclic AMP excretion. With appropriate therapy, serum calcium, phosphorus, alkaline phosphatase, iPTH and 25-OHD3 and urinary and nephrogenous cyclic AMP gradually returned to normal. The response to PTE infusion after normalization of serum electrolytes, iPTH, and 25-OHD3 levels was similar to that seen before therapy. These results demonstrate that non-azotaemic malabsorptive osteomalacia is associated with elevations in urinary and nephrogenous cyclic AMP which gradually fall to normal with therapy. In contrast to studies in the vitamin D deficient rat, the maximal urinary cyclic AMP response to PTE is not diminished in the human with malabsorptive osteomalacia. The lack of a phosphaturic response to PTE depite a normal increase in urinary cyclic AMP excretion, as seen in our patient, is similar to that described in some patients with pseudohypoparathyroidism, suggesting that the response is not specific for the latter disorder. Finally, the data suggest that endogenous PTH does not modulate its renal receptors, at least in terms of cyclic AMP generation.

CONTINUOUS INTRAVENOUS INFUSION OF CALCIUM IN VITAMIN D DEFICIENT RICKETS

PEDIATRICS ◽  
1963 ◽  
Vol 32 (2) ◽  
pp. 272-279
Author(s):  
Christos Cassimos ◽  
Christine Tsenghi ◽  
Sophia Michael ◽  
Argyro Liaromati ◽  
Katerina Metaxotou
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Intravenous Infusion ◽  
Continuous Intravenous Infusion ◽  
Calcium Phosphorus ◽  
Calcium Infusion ◽  
Calcium And Phosphorus

In six patients with vitamin D deficient rickets, aged 4 to 12 months, calcium was administered by continuous intravenous infusion. The total amount of calcium delivered over a period of 9 to 38 days ranged from 2.4 to 13.6 gm. As a result of the infusion, radiologic healing of rickets appeared promptly in the mild cases, but was much delayed in the more severe. The influence of the calcium infusion on calcium, phosphorus, and alkaline phosphatase in the serum, and on calcium and phosphorus in the urine has been discussed.

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

scholarly journals Bone metabolism biomarkers in walking children with cerebral palsy

2020 ◽  
Vol 7 (4) ◽  
pp. 79-86
Author(s):  
Vladimir M. Kenis ◽  
Svetlana L. Bogdanova ◽  
Tatyana N. Prokopenko ◽  
Andrei V. Sapogovskiy ◽  
Tatyana I. Kiseleva
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Cerebral Palsy ◽  
Bone Metabolism ◽  
Control Group ◽  
Study Group ◽  
Flat Feet ◽  
Children With Cerebral Palsy ◽  
Calcium Phosphorus ◽  
Orthopedic Patients

Backgrоund. Osteoporosis is an important factor in the pathogenesis of orthopedic manifestations in children with cerebral palsy. It was previously demonstrated that children with cerebral palsy have specific changes in bone metabolism, which can cause changes in laboratory parameters compared with other orthopedic patients without neurological backgrounds. Aim. The aim of this study was to assess bone metabolism biomarkers in children with cerebral palsy, identifying distinguishing characteristic patterns in comparison with patients with orthopedic pathology without neurological backgrounds. Materials and methods. This study evaluated the concentrations of calcium, phosphorus, -cross laps, osteocalcin, vitamin D, CICP, and alkaline phosphatase in the blood serum of 50 children with cerebral palsy aged between 6 to 12 years with GMFCS levels IIII. The control group consisted of 50 patients with plano-valgus deformities of the feet. Results. The alkaline phosphatase activity in the group of children with cerebral palsy was 170.25 59.35 u/L, while in the control group it was 145.58 46.29 u/L; the CICP concentration in the study group was higher than in the control group (324.01 174.10 and 269.68 240.98, respectively). The concentration of -cross laps, osteocalcin, calcium, and vitamin D in the study group was lower than in children with flat feet. Conclusions. This study demonstrated multidirectional changes in the biomarkers of bone metabolism that are characteristic of walking children with cerebral palsy. These changes are characterized by a corresponding increase in the activity of osteoresorption and osteoreparation. This makes it possible to justify the combined use of metabolites and metabolic activators (calcium and vitamin D) and drugs that suppress osteoresorption (bisphosphonates) for the prevention and treatment of osteoporosis in children with cerebral palsy.

scholarly journals Vitamin D status in children with autoimmune thyroiditis

2017 ◽  
Vol 4 (5) ◽  
pp. 1595
Author(s):  
Gomathi Priya J ◽  
Seenivasan Venkatasamy ◽  
Karamath S Pyarejan ◽  
Jayachandran K.
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Serum Calcium ◽  
Autoimmune Thyroiditis ◽  
Causal Factor ◽  
Vitamin D Status ◽  
Hydroxyvitamin D ◽  
Vitamin D Levels ◽  
Significant Difference ◽  
25 Hydroxyvitamin D

Background: Deficiency of 25 hydroxyvitamin D has been linked with predisposition to autoimmune disorders. Also, vitamin D has been found to be a causal factor in many autoimmune diseases. Objective of the study was to investigate vitamin D status in children with autoimmune thyroiditis attending endocrinology OPD at a tertiary centre in southern India.Methods: It is a case control study done in which 75 children (70 female, 5 male) with age and sex matched healthy controls were chosen. Free thyroxine, TSH, anti TPOAb, anti TGAb, 25 hydroxyvitamin D, serum calcium, phosphorus, alkaline phosphatase levels were estimated in both cases and control subjects. Children with anti TPO or anti TG positivity were divided into four groups based on their level of antibody titers.Results: The mean age in cases was 9.8±0.34 years. 25(OH)D levels were significantly lower in cases (15.07±1.14 ng/ml) compared to controls (17.82±1.13 ng/ml) (p<0.0006). Mean serum calcium levels in cases (9.35±0.16 mg/dl) were significantly lower when compared to controls (9.73±0.14 mg/dl) (p<0.0005). Similarly mean serum alkaline phosphatase level in cases (184.97±11.10 IU/L) were significantly elevated when compared with controls (122.37±6.82 IU/L) (p<0.0001). However, there was no significant difference in serum phosphorus levels between cases (4.42±0.10 mg/dl) and controls (4.43±0.14 mg/dl) (p=0.83). There was no significant difference in vitamin D level among the groups in both anti TPO (p< 0.283) and anti TG (p<0.148).Conclusions: The significant decrease in vitamin D levels in cases signifies that 25(OH)D may be an independent causal factor related to the autoimmunity in thyroid diseases. 

Renal osteodystrophy

2013 ◽  
pp. 1274-1282
Author(s):  
Thomas Bardin ◽  
Tilman Drüeke
Keyword(s):  
Vitamin D ◽  
Bone Turnover ◽  
Serum Calcium ◽  
Renal Osteodystrophy ◽  
Serum Phosphorus ◽  
Osteitis Fibrosa ◽  
Alkaline Phosphatases ◽  
Calcium Phosphorus ◽  
Turnover Markers ◽  
25 Oh Vitamin D

Renal osteodystrophy (ROD) is a term that encompasses the various consequences of chronic kidney disease (CKD) for the bone. It has been divided into several entities based on bone histomorphometry observations. ROD is accompanied by several abnormalities of mineral metabolism: abnormal levels of serum calcium, phosphorus, parathyroid hormone (PTH), vitamin D metabolites, alkaline phosphatases, fibroblast growth factor-23 (FGF-23) and klotho, which all have been identified as cardiovascular risk factors in patients with CKD. ROD can presently be schematically divided into three main types by histology: (1) osteitis fibrosa as the bony expression of secondary hyperparathyroidism (sHP), which is a high bone turnover disease developing early in CKD; (2) adynamic bone disease (ABD), the most frequent type of ROD in dialysis patients, which is at present most often observed in the absence of aluminium intoxication and develops mainly as a result of excessive PTH suppression; and (3) mixed ROD, a combination of osteitis fibrosa and osteomalacia whose prevalence has decreased in the last decade. Laboratory features include increased serum levels of PTH and bone turnover markers such as total and bone alkaline phosphatases, osteocalcin, and several products of type I collagen metabolism products. Serum phosphorus is increased only in CKD stages 4-5. Serum calcium levels are variable. They may be low initially, but hypercalcaemia develops in case of severe sHP. Serum 25-OH-vitamin D (25OHD) levels are generally below 30 ng/mL, indicating vitamin D insufficiency or deficiency. The international KDIGO guideline recommends serum PTH levels to be maintained in the range of approximately 2-9 times the upper normal normal limit of the assay and to intervene only in case of significant changes in PTH levels. It is generally recommended that calcium intake should be up to 2 g per day including intake with food and administration of calcium supplements or calcium-containing phosphate binders. Reduction of serum phosphorus towards the normal range in patients with endstage kidney failure is a major objective. Once sHP has developed, active vitamin D derivatives such as alfacalcidol or calcitriol are indicated in order to halt its progression.

Late Onset Hypocalcemic Seizures in Formula-Fed, Vitamin D Deficient Babies: Revisited

2020 ◽  
Vol 34 (1-2) ◽  
pp. 15-18
Author(s):  
Umar Amin Qureshi ◽  
Abdus Sami Bhat ◽  
Muzaffar Jan ◽  
Uruj Qureshi
Keyword(s):  
Vitamin D ◽  
Breast Feeding ◽  
Serum Calcium ◽  
Late Onset ◽  
Response To Treatment ◽  
Total Serum ◽  
Total Serum Calcium ◽  
Vitamin D Levels ◽  
Calcium Phosphorus ◽  
25 Oh Vitamin D

Purpose: Late onset neonatal hypocalcemia (LNH) is defined as hypocalcemia detected after day 3 of life. Its occurrence in babies fed with cow’s milk is well understood. Since the advent of modern-day formulas, the incidence has however decreased. Methods: A prospective descriptive study (January 2017 to December 2017) of LNH seizures in neonates was conducted. LNH was defined as the total serum calcium of less than 7 mg/dL in preterm or less than 8 mg/dL in term newborns after 72 h of life. Results: 14 neonates were presented with myoclonic and focal seizures due to late hypocalcemia. All were formula fed. Their mean serum calcium, phosphorus, alkaline phosphatase, magnesium, 25-OH vitamin D, intact PTH levels were 4.93 mg/dL, 9.19 mg/dL, 244 U/L, 1.2 mg/dL, 30 nmol/L, 38.6 pg/mL, respectively. Mean maternal vitamin D levels were 43 nmol/L. Mean hospital stay was 4 days. Clinical response to treatment was brisk in those who were able to shift to total breast feeding early. Conclusions: LNH in formula-fed and vitamin D deficient babies is not uncommon. Emphasis should be laid on exclusive breast feeding even in vitamin D deplete mothers. However, mothers at risk should be supplemented with vitamin D during pregnancy.

scholarly journals Deficiency of 25-Hydroxyvitamin D and Dyslipidemia in Indian Subjects

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Jaydip Ray Chaudhuri ◽  
K. Rukmini Mridula ◽  
Alluri Anamika ◽  
Demudu Babu Boddu ◽  
Pradeep Kumar Misra ◽  
...  
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Vitamin D Deficiency ◽  
Serum Glucose ◽  
C Reactive Protein ◽  
Hydroxyvitamin D ◽  
Reactive Protein ◽  
Calcium Phosphorus ◽  
25 Hydroxyvitamin D ◽  
Chemiluminescent Microparticle Immunoassay

Background. Vitamin D deficiency is widespread throughout the world. Several reports have incriminated vitamin D deficiency as the cause of rickets, osteomalacia, and other chronic diseases. Recent studies have suggested a possible link between deficiency of 25-hydroxyvitamin D and dyslipidemia.Aim. To investigate the association between 25-hydroxyvitamin D deficiency and dyslipidemia in Indian subjects.Methodology. We recruited 150 asymptomatic consecutive subjects from patients’ attendees at the Departments of Neurology and Medicine in Yashoda Hospital, Hyderabad, India. Study period was from October 2011 to March 2012. All subjects underwent 25-hydroxyvitamin D assay by chemiluminescent microparticle immunoassay, fasting blood sugar and lipid profile, calcium, phosphorus, alkaline phosphatase, and C-reactive protein (CRP).Results. Out of 150 subjects, men were 82 (54.6%), and mean age was 49.4 (±15.6) years. Among risk factors, hypertension was noted in 63/150 (42%), 25-hydroxyvitamin D deficiency in 59/150 (39.3%), diabetes in 45/150 (30%), dyslipidemia in 60 (40%), smoking in 35/150 (23.3%), and alcoholism in 27/150 (18%). Deficiency of 25-hydroxyvitamin D was significantly associated with dyslipidemia (P=0.0001), mean serum glucose (P=0.0002) mean CRP (P=0.04), and mean alkaline phosphatase (P=0.01). Multivariate analysis showed that 25-hydroxyvitamin D deficiency was independently associated with dyslipidemia (odds ratio: 1.9; 95% CI : 1.1–3.5).Conclusions. We found that deficiency of 25-hydroxyvitamin D was independently associated with dyslipidemia in Indian subjects.

scholarly journals Race, Mineral Homeostasis and Mortality in Patients with End-Stage Renal Disease on Dialysis

2015 ◽  
Vol 42 (1) ◽  
pp. 25-34 ◽  
Author(s):  
Julia J. Scialla ◽  
Rulan S. Parekh ◽  
Joseph A. Eustace ◽  
Brad C. Astor ◽  
Laura Plantinga ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
African American ◽  
African Americans ◽  
Serum Calcium ◽  
Mortality Risk ◽  
Fibroblast Growth Factor 23 ◽  
Total Alkaline Phosphatase ◽  
Mineral Homeostasis ◽  
Calcium Phosphorus ◽  
Total Alkaline

Background: Abnormalities in mineral homeostasis are ubiquitous in patients on dialysis, and influenced by race. In this study, we determine the race-specific relationship between mineral parameters and mortality in patients initiating hemodialysis. Methods: We measured the levels of fibroblast growth factor 23 (FGF23) and 25-hydroxyvitamin D (25 D) in 184 African American and 327 non-African American hemodialysis patients who enrolled between 1995 and 1998 in the Choices for Healthy Outcomes in Caring for ESRD Study. Serum calcium, phosphorus, parathyroid hormone (PTH) and total alkaline phosphatase levels were averaged from clinical measurements during the first 4.5 months of dialysis. We evaluated the associated prospective risk of mortality using multivariable Cox proportional hazards models stratified by race. Results: PTH and total alkaline phosphatase levels were higher, whereas calcium, phosphorus, FGF23 and 25 D levels were lower in African Americans compared to those of non-African Americans. Higher serum phosphorus and FGF23 levels were associated with greater mortality risk overall; however, phosphorus was only associated with risk among African Americans (HR 5.38, 95% CI 2.14-13.55 for quartile 4 vs. 1), but not among non-African Americans (p-interaction = 0.04). FGF23 was associated with mortality in both groups, but more strongly in African Americans (HR 3.91, 95% CI 1.74-8.82 for quartiles 4 vs. 1; p-interaction = 0.09). Serum calcium, PTH, and 25 D levels were not consistently associated with mortality. The lowest and highest quartiles of total alkaline phosphatase were associated with higher mortality risk, but this did not differ by race (p-interaction = 0.97). Conclusions: Aberrant phosphorus homeostasis, reflected by higher phosphorus and FGF23, may be a risk factor for mortality in patients initiating hemodialysis, particularly among African Americans.

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