cholecalciferol and Back-Pain

We recorded the manifestations of severe vitamin D deficiency (VDD) in 40 adolescents before and 3 and 6 months after treatment with a mega dose of cholecalciferol (10 000 IU kg(-1), max 600 000 IU). Significant improvement of symptoms related to VDD was reported in 34/40. Three months after the injection, serus calcium, phosphate, alkaline phosphatase and parathormone were normal in all adolescents with VDD with 25-hydroxyvitamin D (25OHD) level = or >20 ng ml(-1). After 6 months, the majority had 25OHD level <20 ng ml(-1). Two patterns of radiological changes have been recorded with complete healing achieved in all patients after a year of therapy. A mega dose of cholecalciferol is an effective therapy for treatment of VDD in adolescents for 3 months but not for 6 months. Radiographs of the ends of long bones are still valuable tool for diagnosis and follow-up of these patients.

Topics: Adolescent; Alkaline Phosphatase; Arthralgia; Back Pain; Biomarkers; Bone Density Conservation Agents; Calcium; Cholecalciferol; Female; Humans; Injections, Intramuscular; Knee; Male; Muscle Weakness; Parathyroid Hormone; Phosphorus; Prospective Studies; Qatar; Radiography; Risk Assessment; Risk Factors; Severity of Illness Index; Treatment Outcome; Vitamin D Deficiency; Walking; Wrist

Topics: Aged; Back Pain; Calcium; Cholecalciferol; Clinical Trials as Topic; Female; Humans; Intestinal Absorption; Male; Middle Aged; Osteoporosis; Spinal Diseases

Topics: Anti-Inflammatory Agents, Non-Steroidal; Back Pain; Calcium-Regulating Hormones and Agents; Cholecalciferol; Humans; Hypercalciuria; Lumbar Vertebrae; Lumbosacral Region; Male; Mastocytosis, Systemic; Middle Aged; Neck Pain; Osteoporosis; Phenalenes; Treatment Outcome

Topics: Administration, Cutaneous; Adrenal Cortex Hormones; Antirheumatic Agents; Arthritis, Psoriatic; Back Pain; Biopsy; Cholecalciferol; Dendritic Cells; Female; Humans; Immunohistochemistry; Melanoma; Melanoma, Cutaneous Malignant; Methotrexate; Middle Aged; Ointments; PUVA Therapy; Retinoids; Severity of Illness Index; Skin Neoplasms

Pregnancy and lactation-associated osteoporosis (PLO) is very rare, but it can cause severe vertebral compression fractures with disabling back pain. PLO patients have commonly been treated with antiresorptive agents against high bone turnover. There are, however, some concerns regarding the use of bisphosphonates: (1) PLO occurs during the first pregnancy with a high possibility of recurrence during the second pregnancy, (2) long-term outcomes of bisphosphonates in PLO are lacking, and (3) there is a possibility of bisphosphonates accumulated in the bones crossing the placenta. Therefore, alternative therapies must be considered. We analyzed the effect of teriparatide (TPTD), the human recombinant parathyroid hormone (1-34), for 18 months in three women with PLO. Multiple vertebral fractures with severe back pain appeared within 6 months after their first childbirth. Two of them had a family history of osteoporosis. Lactation was discontinued immediately after diagnosis of PLO. Calcium carbonate, cholecalciferol, and TPTD were prescribed. The back pain immediately resolved. Bone mineral density (BMD) increased by 14.5-25.0% (mean 19.5%) at the lumbar spine and by 9.5-16.7% (mean 13.1%) at the femoral neck, after 18 months of treatment. The final Z scores in these PLO patients were nearly normalized. Two women had a second baby without any complication. BMD significantly improved after 18 months of treatment with TPTD without further fractures. In conclusion, TPTD should be considered to avoid long-term morbidity in young patients with PLO and is highly encouraged for use in PLO patients with multiple vertebral fractures.

Topics: Adult; Back Pain; Bone Density; Calcium Carbonate; Cholecalciferol; Diphosphonates; Female; Femur Neck; Fractures, Compression; Humans; Lactation; Osteoporosis; Parathyroid Hormone; Pregnancy; Pregnancy Complications; Spinal Fractures; Teriparatide

Topics: Aged; Aged, 80 and over; Back Pain; Calcium; Cholecalciferol; Diagnosis, Differential; Diphosphonates; Dose-Response Relationship, Drug; Female; Fractures, Compression; Fractures, Spontaneous; Humans; Lumbar Vertebrae; Osteomalacia; Osteoporosis, Postmenopausal; Radiography