Calcium and phosphate metabolism in children with idiopathic hypoparathyroidism or pseudohypoparathyroidism: effects of 1,25-dihydroxyvitamin D3.

Calcium and phosphate metabolism in children with idiopathic hypoparathyroidism or pseudohypoparathyroidism: effects of 1,25-dihydroxyvitamin D3.
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特发性甲状旁腺功能减退症或假性甲状旁腺功能减退症儿童的钙和磷酸盐代谢:1,25-二羟基维生素 D3 的影响。

DOI:
10.1016/s0022-3476(85)80668-5
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发表时间:
1985
期刊:
The Journal of pediatrics
影响因子:
--
通讯作者:
Chinchilli,VM
Chinchilli,VM
中科院分区:
--
文献类型:
--
作者:
Chan,JC;Young,RB;Hartenberg,MA;Chinchilli,VM

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两名先天性甲状旁腺功能减退症儿童和两名假性甲状旁腺功能减退症儿童接受了15 - 45 ng/kg/天的1,25-二羟维生素D3维持剂量,共255个月。治疗后2年尿钙排泄量呈上升趋势,但与10名正常对照组比较无显著性差异。与对照值相比,磷酸盐排泄的肾阈值保持在正常范围内。在此治疗期间发生了2例高钙血症和2例低钙血症。高钙血症在停用1,25-二羟维生素D3后1周内逆转。通过增加1,25-二羟维生素D3的剂量来对抗低钙血症。通过肌酐清除率和血清肌酐浓度倒数估计,肾功能未受到不良影响。1,25-二羟维生素D3治疗期间的平均血清钙浓度显著高于500 - 3000 IU/kg/天剂量维生素D2治疗期间获得的平均血清钙浓度(P=0.001)。这些数据为特发性甲状旁腺功能减退症和假性甲状旁腺功能减退症患者长期使用1,25-二羟维生素D3提供了额外的支持。
Two children with congenital hypoparathyroidism and two children with pseudohypoparathyroidism were given maintenance doses of 15 to 45 ng/kg/day 1,25-dihydroxyvitamin D3for a total of 255 months. The urinary calcium excretion showed an upward elevation after the first 2 years of treatment but was not significantly higher than that in 10 normal control subjects. The renal threshold for phosphate excretion stayed within the normal ranges compared with control values. Two hypercalcemic and two hypocalcemic episodes occurred during this period of treatment. Hypercalcemia was reversed within 1 week after withdrawal of 1,25-dihydroxyvitamin D3. Hypocalcemia was countered by increasing the dose of 1,25-dihydroxyvitamin D3. Renal functions were not adversely affected, as estimated by creatinine clearance and reciprocals of serum creatinine concentrations. The mean serum calcium concentration during 1,25-dihydroxyvitamin D3treatment was significantly higher (P=0.001) compared with that obtained during vitamin D2treatment at a dose of 500 to 3000 IU/kg/day. These data provide additional support for the long-term use of 1,25-dihydroxyvitamin D3in idiopathic hypoparathyroidism and pseudohypoparathyroidism.
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