Studies of the hypercalcaemia of sarcoidosis: effect of steroids and exogenous vitamin D3 on the circulating concentrations of 1,25-dihydroxy vitamin D3.
Studies of the hypercalcaemia of sarcoidosis: effect of steroids and exogenous vitamin D3 on the circulating concentrations of 1,25-dihydroxy vitamin D3.
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结节病高钙血症的研究：类固醇和外源性维生素 D3 对 1,25-二羟基维生素 D3 循环浓度的影响。
DOI：
10.1093/oxfordjournals.qjmed.a067792
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发表时间：
1984
期刊：
影响因子：
--
通讯作者：
J. O'riordan
中科院分区：
文献类型：
--
作者：
L. Sandler;C. Winearls;L. Fraher;T. Clemens;R. Smith;J. O'riordan
6例结节病患者的高钙血症与循环中1，25-二羟基维生素D3（187-475 pmol/l）升高有关：维生素D的这种代谢物的浓度是其前体25-羟基维生素D浓度的函数，其保持在正常范围内。皮质类固醇在降低血清钙时，通过快速降低循环中的1，25-二羟基维生素D3而消除了这种异常的底物-产物关系，同时对25-羟基维生素D没有影响。循环中1，25-二羟基维生素D3的下降先于钙的下降。对外源性1，25-二羟基维生素D3清除率的研究表明，在高钙血症发作期间，固醇的血浆消失时间延迟，并且通过类固醇治疗恢复正常。对这些结节病患者给予维生素D3增加了1，25-二羟基维生素D3的循环浓度，这导致高钙血症，从而解释了他们对维生素D和阳光的超敏反应。
Hypercalcaemia in six patients with sarcoidosis was associated with elevated circulating 1,25-dihydroxy vitamin D3 (187-475 pmol/l): the concentration of this metabolite of vitamin D was a function of the concentration of its precursor, 25-hydroxy vitamin D which remained within the normal range. Corticosteroids, in reducing serum calcium, eliminated this abnormal substrate--product relationship by rapidly reducing circulating 1,25-dihydroxy vitamin D3 while having no effect on 25-hydroxy vitamin D. The fall in circulating 1,25-dihydroxy vitamin D3 preceded the fall of calcium. Studies on the clearance of exogenous 1,25-dihydroxy vitamin D3 indicated that during hypercalcaemic episodes, the plasma disappearance time of the sterol was delayed and that this reverted to normal with steroid therapy. Administration of vitamin D3 to these patients with sarcoidosis increased the circulating concentration of 1,25-dihydroxy vitamin D3 and this resulted in hypercalcaemia, thus accounting for their hypersensitivity to vitamin D and sunlight.