Rickets Associated With Long-Term Anticonvulsant Therapy

PEDIATRICS ◽  
1977 ◽  
Vol 60 (2) ◽  
pp. 261-262
Author(s):  
Francesca Severi ◽  
Maria Clara Gasparoni ◽  
Carla Martini
Keyword(s):  
Alkaline Phosphatase ◽  
Serum Alkaline Phosphatase ◽  
Anticonvulsant Therapy ◽  
Control Population ◽  
Calcium And Phosphorus ◽  
Phosphorus Levels ◽  
At Home

The study presented by Crosley et al. in the July 1975 issue of Pediatrics (page 52) is the first dealing with noninstitutionalized children. A significantly higher value of serum alkaline phosphatase was observed in treated children than in the control population, while calcium and phosphorus abnormalities were minimal in both groups. We concluded a study on the serum alkaline phosphatase, calcium, and phosphorus levels in noninstitutionalized children, including 50 who were from 3 to 14 years old and who were receiving long-term anticonvulsant therapy (either diphenylhydantoin, phenobarbital, or both for more than 12 months) and 57 age-matched controls, all living at home.

Rickets Associated With Long-Term Anticonvulsant Therapy in a Pediatric Outpatient Population

PEDIATRICS ◽  
1975 ◽  
Vol 56 (1) ◽  
pp. 52-57 ◽  
Author(s):  
Carl J. Crosley ◽  
Claire Chee ◽  
Peter H. Berman
Keyword(s):  
Alkaline Phosphatase ◽  
Alkaline Phosphatase Activity ◽  
Serum Alkaline Phosphatase ◽  
Pediatric Population ◽  
Anticonvulsant Therapy ◽  
Control Population ◽  
Serum Alkaline Phosphatase Activity ◽  
Calcium And Phosphorus ◽  
And Control

Over a 12-month period, an ambulatory pediatric population receiving long-term anticonvulsants was surveyed for the presence of biochemical and radiologic rickets. There were 74 treated children and 95 matched controls. Elevations of serum alkaline phosphatase activity occurred in 31 of the 74 (42%) treated children (23 of 47 children between 2 and 10 years and 8 of 21 children between 10 and 16 years). This frequency of abnormal values was significantly greater than that which occurred in our control population. Calcium and phosphorus abnormalities were minimal in both treated and control populations. Radiologic rickets occurred in 6 of the 74 (8%) of the treated children and in none of the control population. Neither the severity of the rickets nor the degree of hyperalkaline phosphatasemia were correlated with age of the patient, duration, and/or dose of anticonvulsant therapy.

Increased serum alkaline phosphatase as a predictor of long-term mortality after stroke

Neurology ◽  
2010 ◽  
Vol 75 (22) ◽  
pp. 1995-2002 ◽  
Author(s):  
W.- S. Ryu ◽  
S.- H. Lee ◽  
C. K. Kim ◽  
B. J. Kim ◽  
B.- W. Yoon
Keyword(s):  
Alkaline Phosphatase ◽  
Serum Alkaline Phosphatase ◽  
Long Term Mortality

Skeletal Blood Flow in Paget's Disease of Bone and its Response to Calcitonin Therapy

1978 ◽  
Vol 54 (1) ◽  
pp. 69-74 ◽  
Author(s):  
R. Wootton ◽  
J. Reeve ◽  
E. Spellacy ◽  
M. Tellez-Yudilevich
Keyword(s):  
Alkaline Phosphatase ◽  
Blood Flow ◽  
Serum Alkaline Phosphatase ◽  
Paget’S Disease ◽  
Paget's Disease ◽  
Short Term ◽  
Urinary Hydroxyproline ◽  
Rapid Fall ◽  
Hydroxyproline Excretion

1. Blood flow to the skeleton was measured by the 18F clearance method of Wootton, Reeve & Veall (1976) in 24 patients with untreated Paget's disease. In every patient but one, resting skeletal blood flow was increased. There was a significant positive correlation between skeletal blood flow and serum alkaline phosphatase and between skeletal blood flow and urinary total hydroxyproline excretion. 2. Fourteen patients were re-studied after they had received short-term (7 days or less) or long-term (7 weeks or more) calcitonin. Skeletal blood flow, alkaline phosphatase and urinary hydroxyproline excretion fell towards normal in every case. There was some evidence from the short-term studies that calcitonin produced a more rapid fall in skeletal blood flow than in alkaline phosphatase. 3. Glomerular filtration rate appeared to increase transiently in response to calcitonin.

Long-Term Follow-up of Hypophosphatemic Bone Disease Associated With Elemental Formula Use: Sustained Correction of Bone Disease After Formula Change or Phosphate Supplementation

2020 ◽  
Vol 59 (12) ◽  
pp. 1080-1085
Author(s):  
Abigail S. Eswarakumar ◽  
Nina S. Ma ◽  
Leanne M. Ward ◽  
Philippe Backeljauw ◽  
Halley Wasserman ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Bone Disease ◽  
Serum Alkaline Phosphatase ◽  
Serum Phosphorus ◽  
Phosphorus Concentration ◽  
Disease Extent ◽  
Elemental Formula ◽  
Radiology Reports ◽  
Phosphate Supplementation

In this article, we describe the long-term outcomes of children who were previously reported to have developed hypophosphatemic bone disease in association with elemental formula use. An extended chart review allowed for an updated report of 34 children with regard to severity/duration of bone disease, extent of recovery, and time to correction using radiology reports and biochemical data. After implementation of formula change and/or phosphate supplementation, we found that serum phosphorus concentration increased and serum alkaline phosphatase activity decreased in all patients, normalizing by 6.6 ± 4.0 (mean ± SD) months following diagnosis. The decrease in serum alkaline phosphatase from diagnosis to the time of correction was moderately correlated with the concurrent increase in serum phosphorus ( R = 0.48, P < .05). Age at diagnosis significantly correlated with time to resolution ( R = 0.51, P = .01). This study supports the earlier report that bone disease associated with hypophosphatemia during elemental formula use responds to formula change and/or phosphate supplementation.

Abnormal Bone Mineral Metabolism after Long-Term Anticonvulsant Treatment

1994 ◽  
Vol 28 (1) ◽  
pp. 47-48 ◽  
Author(s):  
Christopher P. Alderman ◽  
Catherine L. Hill
Keyword(s):  
Alkaline Phosphatase ◽  
Serum Concentration ◽  
Bone Mineral ◽  
Serum Alkaline Phosphatase ◽  
Mineral Metabolism ◽  
Bone Mineral Metabolism ◽  
Hepatic Microsomal Enzyme ◽  
Grand Mal ◽  
Anticonvulsant Treatment

OBJECTIVE: To present a case of anticonvulsant-induced disturbances of bone mineral metabolism associated with long-term phenytoin treatment. CASE SUMMARY: An 87-year-old woman was hospitalized with generalized acroparesthesia. Her medical history was significant for grand mal epilepsy, which had been treated with phenytoin for more than ten years. On admission she was found to be hypocalcemic, and her alkaline phosphatase concentration was markedly elevated. DISCUSSION: Further investigations revealed that the patient's serum concentration of 25-hydroxycalciferol was well below the expected range. Phenytoin treatment was withdrawn, and calcitriol supplementation commenced. Ten weeks later she was normocalcemic, and the calcitriol dosage was reduced. Radiologic investigations at this time revealed an ununited hip fracture, as well as widespread evidence of bone demineralization. CONCLUSIONS: Minor elevations of liver enzymes observed in association with anticonvulsant treatment may reflect hepatic microsomal enzyme induction. Marked elevation of serum alkaline phosphatase, particularly when seen in concert with hypocalcemia, may be markers of anticonvulsant-induced bone disease. Under these circumstances, further radiologic investigations and measurement of the vitamin D serum concentration should be undertaken.

Rickets and Metabolic Disorders

PEDIATRICS ◽  
1990 ◽  
Vol 85 (4) ◽  
pp. 624-625
Author(s):  
SINASI ÖZSOYLU ◽  
AYTEKIN BESIM
Keyword(s):  
Alkaline Phosphatase ◽  
Growth Plate ◽  
Metabolic Disorders ◽  
Short Report ◽  
Cell Disease ◽  
Mucolipidosis Ii ◽  
Calcium And Phosphorus ◽  
Phosphorus Levels

To the Editor.— The short report of Morrison and Kerr1 entitled "Growth Plate: Roentgenologic Findings in a Case of Tyrosinosis" deserves some comments. In addition to phenylketonuria and homocystinuria which were mentioned by the authors, roentgenologic bony changes were shown recently in a 5-month-old boy with mucolipidosis II (I-cell disease).2 Alkaline phosphatase was found to be elevated, and calcium and phosphorus levels were somewhat decreased in most of these cases. With the addition of roentgenologic findings one can be sure that all of these patients had rickets.

Biochemical Changes following Parathyroidectomy

1993 ◽  
Vol 16 (10) ◽  
pp. 700-703 ◽  
Author(s):  
P.K.G. Chandran ◽  
T.J. Ulahannan ◽  
M. Skiles
Keyword(s):  
Alkaline Phosphatase ◽  
Serum Calcium ◽  
Serum Alkaline Phosphatase ◽  
Inorganic Phosphorus ◽  
Biochemical Changes ◽  
Postoperative Hypocalcemia ◽  
Subtotal Parathyroidectomy ◽  
Osteoblastic Activity ◽  
End Stage ◽  
Phosphorus Levels

Biochemical changes that had appeared after subtotal parathyroidectomy (PTx) in 26 patients with end-stage renal failure were observed. The volume of excised parathyroid glands was also measured. Serum calcium and inorganic phosphorus levels fell after PTx; only to rise in due course. Serum alkaline phosphatase levels rose after PTx, reaching a peak by the 14th postoperative day. These elevated levels returned to normal range at about three months after PTx. Strong correlation was noted among the degree of postoperative hypocalcemia, and increase in serum alkaline phosphatase, but not between absolute pre or postoperative alkaline phosphatase levels and changes in serum calcium or phosphorus concentrations. Nevertheless, significant correlation was seen between pre-PTx levels of alkaline phosphatase and its short-lived postoperative rise, indicating hastened osteoblastic activity.

Sign in / Sign up

Export Citation Format

Share Document