cholecalciferol and Osteonecrosis

Topics: Adrenal Cortex Hormones; Adult; Aspirin; Cholecalciferol; Colitis, Ulcerative; Cyclosporine; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Knee Joint; Male; Mesalamine; Osteonecrosis; Pain; Platelet Aggregation Inhibitors; Radiography; Simvastatin; Vitamins

The generic term "Renal Osteodystrophy" is used to denote a complex of skeletal and metabolic impairments found in nephropathic patients. Neither dialytic treatment nor transplant is always capable of limiting the worsening evolution; transplantation, on the contrary, while it does not in many cases bring the phospho-calcic metabolism back to full normality, introduces new elements of imbalance arising as a result of the inevitable immunosuppressive therapy. After outlining the main post-transplant metabolic problems, the Authors discuss the manifestations of orthopaedic interest, in particular the most severe complication, i.e. aseptic necrosis.

Topics: Cholecalciferol; Chronic Kidney Disease-Mineral and Bone Disorder; Femur Head Necrosis; Hip Prosthesis; Humans; Kidney Transplantation; Metabolic Diseases; Nephrotic Syndrome; Osteonecrosis; Osteosclerosis; Parathyroid Hormone; Postoperative Complications; Radiography

The serum levels of 1,25-(OH)2 vitamin D3 were assayed in samples from 12 adolescent patients with SLE. Subnormal levels were observed in 7 of these 12 patients. Low levels of the metabolically active polar metabolite of vitamin D3 may contribute to the development of osteopenia observed in this disease. The cumulative effects of the osteoporotic and anti vitamin D effects of long term steroid therapy in children with SLE may require the cautious administration of supplemental vitamin D.

Topics: Adolescent; Adult; Child; Cholecalciferol; Humans; Hydroxycholecalciferols; Lupus Erythematosus, Systemic; Osteonecrosis; Prednisone; Time Factors

Young rabbits on high (0.57%) or low (0.24%) calcium were given an aqueous extract of Solanum malacoxylon (S.m.) leaves (20 g dried leaves/200 ml distilled water) intragastrically at 0, 12 and 36 hours. On bothe diets S.m. induced progressive hypophosphatasemia but serum calcium and phosphorus underwent only minor changes. In rabbits necropsied at 0, 12, 36, 60, 84 and 108 hours, S.m. was shown to have a negative effect on the resorbing osteocytes. With retarded osteocytic osteolysis, osteopetrosis resulted. Further regressive changes in the osteocytes resulted in osteonecrosis which was observed within 12 hours after administration of S.m. extract. The osteonecrosis, combined with retarded apposition, later resulted in osteopenia. It was concluded that the recommended dietary calcium for growing rabbits--about 0.6%--is too high. Whereas the histologic appearance of bone in rabbits fed low calcium was normal, bones from rabbits on high calcium showed retarded resorption and the rabbits had a relative hypophosphatasemia.

Topics: Alkaline Phosphatase; Animals; Bone Resorption; Calcium; Cholecalciferol; Female; Male; Osteonecrosis; Osteopetrosis; Phosphorus; Plant Extracts; Plant Poisoning; Rabbits