dihydrotachysterol and Hypocalcemia

1. Hypo- and hypercalcemia can be explained as derangements of the calcium homeostasis. Hypocalcemic tetany usually alarming the patient tremendously is, at least in adults, rarely life-threatening. Hypercalcemia leads in 30% of the cases to clinical symptoms which may inadvertedly pass into a state of hypercalcemic crisis. This latter requires an often difficult emergency treatment. 2. Hypocalcemic tetany may be reversed by administering calcium i.v. or, in severe cases, by a calcium infusion. Only rarely are magnesium supplements necessary to let the tetany disappear. Vitamin D or dihydrotachysterol (DHT) do not correct hypocalcemia immediately, since their effects may be delayed up to 15-25 days. In order to normalize the serum calcium permanently, vitamin D or DHT treatment should be instituted as rarely as possible. 3. Initially, hypercalcemic crisis is best treated by forced intravenous fluid administration with normal saline (and furosemide) in combination with high doses of prednisone. Fluid-, sodium- and potassium balances ought to be checked during this type of treatment. A first evaluation of the effectiveness of these measures is recommended after 24 hours: treatment is continued in patients who respond favorably, while subjects who do not show a significant decrease of the serum calcium may either be given a phosphate infusion or mithramycine as a bolus. Calcitonin appears to be useful only to start treatment before institution of a phosphate infusion.

Topics: Calcium; Dihydrotachysterol; Emergencies; Furosemide; Homeostasis; Humans; Hypercalcemia; Hypocalcemia; Prednisone; Sodium Chloride; Tetany; Vitamin D; Water-Electrolyte Balance

Topics: Animals; Anticonvulsants; Biotransformation; Contraceptives, Oral; Diet; Dihydrotachysterol; Diuretics; Drug Resistance; Emotions; Estrogens; Female; Homeostasis; Humans; Hydroxycholecalciferols; Hypercalcemia; Hypocalcemia; Hypoparathyroidism; Magnesium Deficiency; Parathyroid Hormone; Phosphates; Stress, Psychological; Tranquilizing Agents; Vitamin D

Topics: Adenoma; Alkaline Phosphatase; Calcitonin; Calcium; Dihydrotachysterol; Diuretics; Ergocalciferols; Female; Homeostasis; Humans; Hydroxyproline; Hyperparathyroidism; Hypocalcemia; Hypoparathyroidism; Male; Middle Aged; Osteitis Deformans; Parathyroid Glands; Parathyroid Hormone; Parathyroid Neoplasms; Phosphates; Sulfonamides; Thiadiazines

Fifty elderly patients with hypocalcaemia were randomly treated for 8 weeks with either oral dihydrotachysterol, parenteral cholecalciferol or oral alfacalcidol. All three treatments were successful in normalizing the serum calcium levels in most patients within 2 weeks. Hypercalcaemia was seen only with alfacalcidol but was rapidly reversed once treatment was discontinued. Hypercalcaemia was not observed with either dihydrotachysterol or cholecalciferol. These therefore, require less frequent biochemical monitoring. A single cholecalciferol injection eliminates the problems of compliance.

Topics: Aged; Aged, 80 and over; Cholecalciferol; Dihydrotachysterol; Humans; Hydroxycholecalciferols; Hypocalcemia

Topics: Alkaline Phosphatase; Bone and Bones; Dihydrotachysterol; Humans; Hydroxycholecalciferols; Hyperparathyroidism; Hypocalcemia; Kidney Failure, Chronic; Kidney Transplantation; Parathyroid Hormone; Renal Dialysis; Ultraviolet Therapy

A 4-year-old castrated male domestic ferret (Mustela putorius furo) was examined because of a 3-week history of intermittent seizures, signs of depression, hypocalcemia, and hyperphosphatemia.. Plasma biochemical analysis confirmed hyperphosphatemia (17.7 mg/dL) and low concentrations of total (4.3 mg/dL) and ionized (0.49 mmol/L) calcium. Serum parathyroid hormone concentration (2.30 pmol/L) was low or in the low part of the reference interval.. Calcium gluconate was administered (2.0 mg/kg/h [0.9 mg/lb/h], IV), followed by a transition to administration of calcium carbonate (53 mg/kg [24.1 mg/lb], PO, q 12 h) and dihydrotachysterol (0.02 mg/kg/d [0.009 mg/lb/d], PO). Attitude of the ferret improved and seizures ceased as blood calcium concentrations increased. The ferret was reexamined because of seizures approximately 1 year after oral maintenance administration of dihydrotachysterol and calcium was initiated. The ferret responded well to emergency and long-term treatment but then was lost to follow-up monitoring. The ferret died approximately 2 years after the initial evaluation and treatment. Hypertrophic cardiomyopathy was diagnosed during necropsy, but the parathyroid glands could not be identified.. To the authors' knowledge, primary hypoparathyroidism has not previously been reported in a ferret. The condition should be considered for ferrets with hypocalcemia and hyperphosphatemia without azotemia. Treatment with dihydrotachysterol and oral supplementation of calcium appeared to be a viable option for long-term management.

Topics: Animals; Calcium Carbonate; Calcium Gluconate; Dihydrotachysterol; Ferrets; Hypocalcemia; Hypoparathyroidism; Male; Vitamins

Topics: Bone Density Conservation Agents; Calcium Carbonate; Dihydrotachysterol; Diphosphonates; Female; Gastroenteritis; Humans; Hypercalcemia; Hypocalcemia; Hypoparathyroidism; Middle Aged; Pamidronate; Renal Insufficiency; Thyroiditis

Parathyroid autotransplantation was first described in 1907 by Halsted. However, this simple and effective method of preserving parathyroid function has been used with increasing frequency only during the past 25 years. Beginning in the late 1960s, our group has transplanted normal parathyroid tissue into the ipsilateral sternocleidomastoid muscle whenever these glands could not be preserved in situ with adequate blood supply. In addition, if the blood supply of all four parathyroid glands appeared compromised, cryopreservation of parathyroid tissue was performed in case the autotransplanted tissue did not function after surgery. Since 1970, 393 patients underwent a total thyroidectomy. Parathyroid glands that could not be saved in situ were biopsied to confirm their identity by frozen section and then autotransplanted. Of the 393 patients who underwent a total thyroidectomy, 261 patients required transplantation of one or more glands. Among those 261 patients who underwent selective parathyroid autotransplantation, 33 (13%) required temporary calcium and vitamin D supplementation. Of these 33 patients, 2 (less than 1%) had permanent hypoparathyroidism and are receiving long-term vitamin D therapy.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Calcium Carbonate; Child; Child, Preschool; Dihydrotachysterol; Ergocalciferols; Follow-Up Studies; Humans; Hypocalcemia; Hypoparathyroidism; Middle Aged; Neck Muscles; Parathyroid Glands; Phosphates; Thyroidectomy; Transplantation, Autologous

One of the post-operative complications of total thyroidectomy is the onset of a transitory or permanent hypocalcemic syndrome. Hypocalcemia is caused by different physiopathological mechanisms that operate either individually or in association (parathyroidal deficit, deficiency of bone calcium subsequent to parathyroid osteodystrophy, acute emission of calcitonin into the circulation). Calcemia levels were studied p.o. in a selected group of 25 patients who had undergone total extracapsular thyroidectomy with the apparent preservation of the parathyroid glands. Totals thyroidectomy has been performed in 15 patients with euthyroid goitre, in 4 with papillary carcinoma, in 3 with diffuse toxic goitre and in 3 with multinodular toxic goitre. Eight patients received drug and diet therapy since calcemia levels were lower than 7.5 mg/ml. Fifteen days after the operation, calcemia levels in 21 patients were subliminal and dihydrotachysterol therapy was commenced. Hypocalcemia was permanent in only one case.

Topics: Calcium; Dihydrotachysterol; Humans; Hypocalcemia; Syndrome; Thyroidectomy

Topics: Aged; Calcitriol; Dihydrotachysterol; Drug Resistance; Humans; Hypocalcemia; Magnesium; Magnesium Deficiency; Male; Parathyroid Glands

After 13 days therapy with 30 mg dihydrotachysterol (dihydrotachysterin, AT 10 (DHT3 daily in a 33-year-old female patient a severe intoxication developed. In addition to this the patient was twice administered calcium gluconate and vitamin D. Typical clinical symptoms of the developing hypercalcaemia syndrome consisted in adynamia, vomiting and obstipation. The occurring clinical symptom and findings are discussed on the basis of recent knowledge concerning efficacy and metabolism of DHT3 as well as vitamin D3.

Topics: Adult; Calcium; Dihydrotachysterol; Female; Humans; Hypercalcemia; Hypocalcemia

The metabolism of vitamin D is essential in the control of bone and mineral metabolism. Hyperthyroidism as well as hypothyroidism effect the metabolism of bone tissue and vitamin D. We present a dihydrotachysterol-calcium treated patient with post-operative hypothyroidism, who developed hypercalcaemia, when the thyroxine dosage was increased.

Topics: Calcium; Dihydrotachysterol; Female; Humans; Hypercalcemia; Hypocalcemia; Hypothyroidism; Middle Aged; Postoperative Complications; Thyroxine

Topics: Child; Dihydrotachysterol; Humans; Hypocalcemia; Hypoparathyroidism; Malabsorption Syndromes; Male; Psoriasis

Calcium excretion from rat intestine was measured by placing distilled water in an intestinal loop in situ and measuring the calcium content after various intervals. More calcium was excreted from the intestine of 18-month-old rats than that of 1-month-old rat. Acute hypocalcemia failed to change the intestinal calcium excretion significantly. Parathyroidectomy decreased intestinal calcium excretion and administration of Parathyroid Extract reversed it. Renal damage produced by injection of Na-sulfacetylthiazole increased the intestinal calcium excreation but dihydrotachysterol reversed it. Gastrin at 200 microng/kg increased the intestinal calcium excretion. Calcium excretion, like calcium absorption, appears to be controled by various endocrine factors and the method of intestinal loop in situ appears to be useful to study the part played by these factors.

Topics: Animals; Calcium; Dihydrotachysterol; Gastrins; Hypocalcemia; Intestinal Mucosa; Male; Parathyroid Glands; Parathyroid Hormone; Rats; Thiazoles

Topics: Adult; Calcium; Dihydrotachysterol; Female; Humans; Hypocalcemia; Hypoparathyroidism; Male; Middle Aged; Postoperative Care; Tetany; Thyroidectomy; Vitamin D

Four patients with gastrointestinal disorders, and one patient with chronic alcoholism presented with both hypocalcemia and hypomagnesemia. Pharmacological doses of either ergocalciferol or dihydrotachysterol did not correct the hypocalcemia except in one patient who had a minimal rise in serum calcium. Parathormone levels were high in three patients and exogenous parathormone given to the fourth subject failed to elicit a rise in serum calcium, implying impairment of the calcemic response to parathormone. Magnesium repletion simultaneously corrected the hypomagnesemia and hypocalcemia. Balance data suggested that the rise in serum calcium was in part, at least, due to increased mobilization of minerals from bone. While the mechanism remains speculative, it appears that magnesium facilitates the release of calcium from bone in the presence of adequate amounts of vitamin D and parathormone.

Topics: Adolescent; Adult; Alcoholism; Bone and Bones; Calcium; Dihydrotachysterol; Drug Resistance; Gastrointestinal Diseases; Humans; Hypocalcemia; Magnesium; Magnesium Deficiency; Middle Aged; Parathyroid Hormone; Phosphorus; Vitamin D

Topics: Calcium; Child; Diet; Dihydrotachysterol; Ergocalciferols; Humans; Hypercalcemia; Hypocalcemia; Hypoparathyroidism; Magnesium; Male; Phosphorus; Vitamin D

Rats raised from weaning on regiments adequate in calcium and phosphorus but deficient in vitamin D will have no detectable intestinal calcium-binding proteins (CaBP), whether or not they show other signs of vitamin D deficiency, such as hypocalcemia. When hypocalcemic, vitamin D-deficient animals were treated with 25-hydroxycholecalciferol, a vitamin D metabolite, they showed a dose-dependent increase in plasma calcium and CaBP; both responses can be described by a single linear relationship, which appears to apply whether the metabolite is 25-hydroxycholecalciferol or dihydrotachysterol. Since vitamin D status is only one determinant of plasma calcium, whereas CaBP (or its expression) appears to depend on vitamin D quantitatively, CaBP may be used as an index of vitamin D status, provided calcium intake is controlled.

Topics: Animals; Calcium; Calcium, Dietary; Carrier Proteins; Dihydrotachysterol; Hydroxycholecalciferols; Hypocalcemia; Intestinal Mucosa; Male; Rats; Time Factors; Vitamin D Deficiency

Topics: Adolescent; Anticonvulsants; Body Height; Body Weight; Calcium; Child; Dihydrotachysterol; Epilepsy, Tonic-Clonic; Ergocalciferols; Humans; Hypocalcemia; Hypoparathyroidism; Male; Middle Aged; Osteomalacia; Rickets; Time Factors; Ultraviolet Therapy; Vitamin D

Topics: Adolescent; Anticonvulsants; Dihydrotachysterol; Electroencephalography; Humans; Hypocalcemia; Male; Pseudohypoparathyroidism

Topics: Administration, Oral; Adolescent; Calcium; Dihydrotachysterol; Drug Resistance; Drug Synergism; Electrocardiography; Female; Humans; Hydroxylation; Hypocalcemia; Hypoparathyroidism; Injections, Intramuscular; Magnesium; Vitamin D

Topics: Animals; Cell Nucleus; Cytoplasm; Dihydrotachysterol; Endoplasmic Reticulum; Female; Gestational Age; Hypercalcemia; Hypocalcemia; Maternal-Fetal Exchange; Microscopy, Electron; Mitochondria; Organoids; Parathyroid Glands; Pregnancy; Rats

Topics: Adolescent; Dihydrotachysterol; Ergocalciferols; Female; Humans; Hypocalcemia; Hypoparathyroidism; Hypophosphatemia, Familial; Infant; Male; Protein-Losing Enteropathies; Pseudohypoparathyroidism

Topics: Adenosine Monophosphate; Adolescent; Alkaline Phosphatase; Amino Acids; Bone and Bones; Child; Child, Preschool; Cholecalciferol; Creatinine; Digestive System; Dihydrotachysterol; Humans; Hydroxycholecalciferols; Hyperparathyroidism; Hypocalcemia; Kidney; Male; Parathyroid Hormone; Rickets; Vitamin D

Topics: Calcium; Dihydrotachysterol; Electrocardiography; Heart; Humans; Hypocalcemia; Myocardial Infarction; Quinidine

Topics: Adolescent; Adult; Aged; Aging; Animals; Calcitonin; Calcium; Calcium Isotopes; Child; Dihydrotachysterol; Edetic Acid; Estrogens; Female; Femur; Humans; Hypocalcemia; Iodine Isotopes; Kidney; Male; Middle Aged; Osteoporosis; Parathyroid Hormone; Rats; Thiazoles

Topics: Acupuncture Therapy; Adult; Calcium; Dihydrotachysterol; Ergocalciferols; Female; Humans; Hypocalcemia; Hypoparathyroidism; Middle Aged; Tetany

Topics: Animal Feed; Animals; Calcitonin; Calcium, Dietary; Cell Membrane; Cytoplasmic Granules; Diet; Dihydrotachysterol; Female; Glycerophosphates; Hypercalcemia; Hypocalcemia; Parathyroid Glands; Parathyroid Hormone; Phosphates; Rats

Topics: Alkalosis; Calcium; Celiac Disease; Dihydrotachysterol; Humans; Hypocalcemia; Hypoparathyroidism; Infant; Infant, Newborn; Laryngismus; Magnesium Deficiency; Pseudohypoparathyroidism; Pseudopseudohypoparathyroidism; Seizures; Tetany; Vitamin D

Topics: Adolescent; Alkaline Phosphatase; Bone Development; Diagnosis, Differential; Dihydrotachysterol; Gait; Growth; Humans; Hyperparathyroidism; Hypocalcemia; Hypoparathyroidism; Male; Phosphorus; Radiography; Rickets

Topics: Adult; Bone and Bones; Calcium; Calcium Isotopes; Cholecalciferol; Creatine; Dihydrotachysterol; Humans; Hydroxyproline; Hypocalcemia; Hypoparathyroidism; Male; Parathyroid Hormone; Phosphates; Radiometry; Tritium; Vitamin D

Topics: Calcium; Child; Child, Preschool; Dihydrotachysterol; Female; Humans; Hypercalcemia; Hypocalcemia; Hypophosphatemia, Familial; Infant; Male; Rickets; Switzerland; Vitamin D

Topics: Brain Diseases; Diagnosis, Differential; Dihydrotachysterol; Female; Humans; Hypocalcemia; Hypoparathyroidism; Mental Disorders; Middle Aged; Phosphorus; Vitamin D

Topics: Calcium; Chemistry, Pharmaceutical; Dihydrotachysterol; Drug Therapy; Humans; Hypocalcemia; Hypoparathyroidism; Pharmacology; Thyroidectomy; Toxicology

Topics: Dihydrotachysterol; Drug Therapy; Ergocalciferols; Humans; Hyperparathyroidism; Hypocalcemia; Hypoparathyroidism; Tetany

Topics: Adrenal Cortex Hormones; Basal Ganglia; Calcinosis; Cataract; Cholecystectomy; Dihydrotachysterol; Drug Therapy; Ganglia; Humans; Hypocalcemia; Hypoparathyroidism; Pancreatitis; Pneumonia; Postoperative Complications; Radiography, Thoracic; Sarcoidosis; Tetanus; Tetanus Toxoid