dihydrotachysterol and Acute-Disease

The reported coincidence of primary hyperparathyroidism and cholelithiasis led us to investigate the effects of acute and chronic hypercalcemia on bile secretion in cats. Acute hypercalcemia (6-7 mmol/liter) was induced by an intravenous calcium infusion. Chronic hypercalcemia (3-4 mmol/liter) was induced and maintained for 8-10 weeks by treatment with subcutaneous vitamin D3, oral dihydrotachysterol, and feeding a calcium-rich diet. Bile secretion was then studied in acute experiments. We found that calcium concentrations in serum and hepatic bile were similar during all experimental normo- or hypercalcemic conditions (y = 1.12x - 0.85; r = 0.76). Biliary volume outputs were significantly decreased during both acute (P less than 0.002) and chronic (P less than 0.05) hypercalcemia compared with normocalcemic controls. Acute hypercalcemia also decreased total bile acid outputs (P less than 0.05), but had no effect on biliary bile acid concentrations. The inhibitory effect of acute hypercalcemia on biliary fluid and bile acid secretion was dose dependent and not antagonized by atropine. These findings suggest that calcium is secreted in hepatic bile at similar concentrations as present in the serum and that elevations of serum calcium concentration inhibit biliary volume and bile acid secretion in cats. Similar effects of hypercalcemia on bile composition in humans might promote calcium salt precipitation in bile.

Topics: Acute Disease; Animals; Bile; Bile Acids and Salts; Calcium; Calcium, Dietary; Cats; Cholecalciferol; Chronic Disease; Dihydrotachysterol; Female; Hypercalcemia; Male

Hyperparathyroidism during pregnancy is an uncommon condition. Several case reports and literature reviews in the last two decades have reported only benign tumors but have demonstrated that this disease is associated with significant neonatal morbidity and mortality as well as maternal morbidity. Parathyroid carcinoma is a rare disease entity associated with a much more severe course and prognosis than parathyroid adenomas; it has not been reported in a pregnant woman. We report here a case of a hyperfunctioning parathyroid carcinoma that presented as acute pancreatitis in pregnancy. The details of the case management and outcome in both the patients and infant are discussed. A summary of the literature on the findings and management of parathyroid carcinoma is also discussed in relation to this case report.

Topics: Acute Disease; Adult; Calcium; Diagnosis, Differential; Dihydrotachysterol; Female; Humans; Hyperparathyroidism; Infant, Newborn; Pancreatitis; Parathyroid Neoplasms; Pregnancy; Pregnancy Complications

Topics: Acute Disease; Adult; Brain Diseases; Bromides; Calcium; Calcium Gluconate; Dihydrotachysterol; Disaccharides; Female; Gluconates; Humans; Hypercalcemia

Topics: Acute Disease; Adenoma; Blood Volume; Central Venous Pressure; Dihydrotachysterol; Female; Furosemide; Humans; Hypercalcemia; Hyperparathyroidism; Middle Aged; Parathyroid Neoplasms; Phosphates; Plasma Substitutes; Renal Dialysis

Topics: Acute Disease; Calcium; Dihydrotachysterol; Goiter; Humans; Hypoparathyroidism; Postoperative Complications; Switzerland; Tetany; Vitamin D