cholecalciferol and Fibrous-Dysplasia-of-Bone

We analyzed transiliac bone biopsy specimens from 30 end-stage renal failure patients, taken at the time of admission for CAPD training. Results were compared with values of iPTH, bone alkaline phosphatase, 1,25-dihydroxyvitamin D3, skeletal survey, quantitative computed tomography (QCT) and single photon absorptiometry (SPA) bone density measurements. Osteitis fibrosa was the most common histological diagnosis, present in 15 of the 30 patients (50%), with eight classified as "severe" and seven as "mild." Eight patients (27%) had adynamic bone lesion, four mixed renal osteodystrophy (13%), and two (7%) osteomalacia. The mean age of the adynamic group was higher than the osteitis fibrosa group (41 +/- 12.1 vs. 56 +/- 10.2 years; P < 0.01), and than the mixed group (39 +/- 7.5 vs. 56 +/- 10.2 years; P < 0.02). Levels of iPTH enabled discrimination between groups, but not between individual patients, and values correlated with bone alkaline phosphatase (r = 0.62; P < 0.001). Erosion of the terminal phalanges was seen on the plain X-rays of 7 of 15 patients with mild or severe OF, and in three patients with another diagnosis. The majority of patients (> 90%) had bone density measurements within the normal range. No significant correlation existed between QCT or SPA scores and any of the histomorphometric parameters, or iPTH. We conclude that iPTH is the most helpful non-invasive investigation in this group of patients. Plain X-ray of the hands is the most useful radiological investigation, but single measurements of bone density are not diagnostic.

Topics: Adult; Aged; Biopsy; Bone and Bones; Bone Density; Cholecalciferol; Female; Fibrous Dysplasia of Bone; Humans; Kidney Failure, Chronic; Male; Middle Aged; Osteomalacia; Parathyroid Hormone; Radioimmunoassay; Tomography, X-Ray Computed

We report a rare case of Albright's syndrome associated with both a soft-tissue myxoma and hypophosphataemic osteomalacia. Renal tubular function was preserved, except for glycosuria. Serum levels of 1,25(OH)2 vitamin D3 were normal. Excision of the myxoma did not influence the biochemical abnormalities, nor did standard doses of vitamin D3 or 1 alpha-OH vitamin D3. The previously reported cases of hypophosphataemic osteomalacia associated with fibrous dysplasia and mesenchymal tumours are reviewed and the underlying mechanism discussed.

Topics: Cholecalciferol; Female; Fibrous Dysplasia of Bone; Humans; Hydroxycholecalciferols; Hypophosphatemia, Familial; Middle Aged; Myxoma; Osteomalacia; Soft Tissue Neoplasms; Syndrome

A female pet wooly monkey with metabolic bone disease initially presented with a proliferating bony mass in the left humerus which had many features of osteosarcoma. At necropsy, parathyroid hyperplasia, osteoclastic resorption, proliferative osteoid deposition in the calvarium and cortex of long bones, and fibrous proliferation of the marrow indicated the presence of generalized osteodystrophia fibrosa. The dietary history of deficient vitamin D3 and protein and minimal exposure to sunlight supported this diagnosis, as did depressed levels of serum calcium and elevated levels of serum parathyroid hormone, alkaline phosphatase, and acid phosphatase.

Topics: Animals; Bone Neoplasms; Calcium; Cholecalciferol; Diagnosis, Differential; Female; Fibrous Dysplasia of Bone; Haplorhini; Humerus; Monkey Diseases; Osteosarcoma; Vitamin D Deficiency

Topics: Adolescent; Child; Child, Preschool; Cholecalciferol; Female; Fibrous Dysplasia of Bone; Fibrous Dysplasia, Polyostotic; Humans; Hypophosphatemia, Familial; Phosphates

Topics: Cholecalciferol; Dihydrotachysterol; Fibrous Dysplasia of Bone; Humans; Neoplasms, Glandular and Epithelial; Osteitis; Tetany