dihydrotachysterol and Hypoparathyroidism

Hypercalcemia is not a rare event and can lead to severe consequences. Its main etiologies are primary hyperparathyroidism and neoplasic conditions. The iatrogenic etiology by vitamin D intoxication is more rarely found.. A 76-year-old finish woman comes to the emergency room for chest pain. Her medical history is impossible to specify due to the language barrier and initial confusion. She has severe hypercalcaemia (4.14mmol/L), renal insufficiency, cardiac arrhythmia later complicated by an ischemic cardiac episode. Clinic and biologic examinations initially guided the research towards a hematological and neoplasic pathology. The iatrogenic etiology will be permitted by the contribution of details on its medical history and treatment learnt secondly. She was treated for post-surgical hypoparathyroidism by dihydrotachysterol, a vitamin D derivative. The cessation of substitution, treatment with hydration and biphosphonates allowed the rapid correction of hypercalcemia.. Dihydrotachysterol intoxication is a rare etiology of hypercalcemia. Because of the longer half-life of this molecule, the risk of hypercalcemia seems to be greater than with other vitamin D derivatives. This molecule, withdrawn from the French market in 1982, is not detected by the dosage of 25 and 1.25 OH vitamin D.. We report an original case of intoxication by dihydrotachysterol. The risk of hypercalcemia encountered with this molecule must be known. The close medical follow-up recommended in case of hypoparathyroidism seems to be particularly necessary in case of supplementation by this molecule.

Topics: Aged; Calcium; Dihydrotachysterol; Diphosphonates; Female; Fluid Therapy; Humans; Hypercalcemia; Hypoparathyroidism; Iatrogenic Disease; Vitamin D

Topics: Dihydrotachysterol; Humans; Hypoparathyroidism

The half synthetic Vitamin D analogue dihydrotachysterol (DHT) is widely used for hypocalcaemic hypoparathyroidism following surgical removal of parathyroids. Such treatment generally initiated by surgeons right after surgery has to be continued in clinical practice. Unfortunately, the required careful monitoring of calcium metabolism is often lacking and as demonstrated may lead to life-threatening conditions.. Here we report on five patients referred to our nephrology unit because of unknown impairment of renal function during therapy with DHT. All patients had clinical signs of hypercalcaemia. Since most symptoms are nonspecific they were not perceived by primary care physicians. In fact DHT treatment was continued for 4 - 50 years. In all cases calcium levels were determined after inadequate long intervals ranging from 3.08 to 4.97 mmol/l. Creatinine levels ranged from 277 to 365 micromol/l. All patients suffered from symptoms of severe hypercalcaemia, three of them needing intensive care unit treatment.. All patients were treated effectively with a regimen consisting of intravenous saline, a loop diuretic, and application of bisphosphonates. As confirmed by renal biopsy persisting alleviation of renal function was due to calcifications. After discontinuation of DHT therapy patients were safely switched to shorter acting vitamin D derivates maintaining a normal calcium level.. In comparison to short acting vitamin-D derivates hypercalcaemic episodes with DHT appear to last longer and may therefore occur with higher incidence. A future option could be the use of synthetic parathyroid hormone (s-PTH) recently shown to be safe and effective. Nevertheless a customized therapy and careful monitoring is indispensable in any case to prevent irreversible organ damage.

Topics: Aged; Dihydrotachysterol; Drug Monitoring; Female; Humans; Hypercalcemia; Hypoparathyroidism; Male; Renal Insufficiency; Vitamin D

Topics: Adult; Calcium; Carbimazole; Congenital Hypothyroidism; Dihydrotachysterol; Female; Humans; Hyperparathyroidism; Hyperthyroidism; Hypoparathyroidism; Hypothyroidism; Infant, Newborn; Parathyroid Diseases; Parathyroid Glands; Pregnancy; Pregnancy Complications; Propylthiouracil; Puerperal Disorders; Thyroid Diseases; Thyroxine

Topics: Adenoma; Child; Dihydrotachysterol; Female; Humans; Hypercalcemia; Hyperparathyroidism; Hypoparathyroidism; Infant, Newborn; Infant, Newborn, Diseases; Parathyroid Diseases; Parathyroid Neoplasms; Pregnancy; Pseudohypoparathyroidism; Vitamin D

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: Animals; Bone and Bones; Calcium; Calcium, Dietary; Chickens; Dihydrotachysterol; Dihydroxycholecalciferols; Feedback; Hydroxycholecalciferols; Hydroxylation; Hypoparathyroidism; Intestinal Absorption; Intestinal Mucosa; Kidney; Kidney Failure, Chronic; Liver; Parathyroid Hormone; Phosphorus; Rats; Strontium; 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

Topics: Adult; Age Factors; Anemia, Pernicious; Calcium; Candidiasis; Child; Dihydrotachysterol; Endocrine System Diseases; Ergocalciferols; Humans; Hypoparathyroidism; Infant, Newborn; Infant, Newborn, Diseases

Topics: Acetates; Calcium; Calcium Chloride; Calcium Phosphates; Cholecalciferol; Citrates; Dihydrotachysterol; Ergocalciferols; Gluconates; Humans; Hypoparathyroidism; Lactates; Magnesium; Parathyroid Hormone; Potassium; Salicylates; Thiosulfates; Vitamin D

Topics: Adolescent; Cholecalciferol; Clinical Trials as Topic; Dihydrotachysterol; Drug Evaluation; Female; Humans; Hypoparathyroidism; Male

In order to clarify the mechanisms of thiazide diuretic-induced hypocalciuria, the effect of a thiazide was studied for 7 days in seven patients with hypoparathyroidism on Vitamin D and one on calcium infusion, and seven euparathyroid patients with hypercalciuria. In the control group, calcium excretion (mg/24 hr) fell by 44% from 415 to 232 within 4 days and remained at this level. Plasma total calcium corrected for total protein did not change. In the hypoparathyroid group, calcium excretion fell by 11% from 351 to 311 and then returned to the base line level. Plasma total calcium (mg/100 ml) increased from 10.09 to 10.88, 11.29 and 10.77 at the end of the 2nd, 4th, and 7th day of thiazide administration. In the patient having i.v. calcium and no Vitamin D, neither plasma nor urinary calcium changed significantly. In both groups sodium excretion increased on the first 2 days and fell to or below base line level thereafter. Urinary phosphate, magnesium, and potassium increased, plasma phosphate rose, and magnesium and potassium fell. It is concluded that: (a) The hypocalciuric effect of thiazides requires the presence of parathyroid hormone and is not solely a result of sodium depletion. (b) The hypercalcemic effect of thiazides in hypoparathyroidism is due to increased release of calcium from bone and requires the presence of a pharmacologic dose of Vitamin D. (c) Thiazides enhane the action of parathyroid hormone on bone and kidney; Vitamin D can replace parathyroid hormone in this interaction in bone but not in kidney.

Topics: Adult; Aged; Bone and Bones; Calcium; Chlorothiazide; Cholecalciferol; Clinical Trials as Topic; Dihydrotachysterol; Drug Interactions; Ergocalciferols; Female; Humans; Hypoparathyroidism; Kidney Tubules; Magnesium; Male; Methyclothiazide; Middle Aged; Natriuresis; Parathyroid Hormone; Phosphates; Potassium; Urinary Calculi; Vitamin D

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

This observational study analyzes Ca-P metabolism and its impact on bone mass accrual and density and the muscle-bone mass/mass relationships in male and female children and adolescents who were parathyroidectomized because of thyroid carcinoma. Two hundred and eight children and adolescents (119 girls and 89 boys) from Gomel city (Belarus) and its rural surroundings were referred to our institution after having undergone total thyroidectomy for the treatment of advanced papillary thyroid cancer. A subgroup of children with demonstrated primary hypoparathyroidism received dihydrotachysterol (AT-10) and/or Ca supplementation. Among routine procedures over a maximum follow-up period of 5 years (average 3.7 years, maximum 8 visits), whole-body scans were taken using dual energy X-ray absorptiometry (DXA) at each visit in order to determine whole-body bone mineral content (TBMC), projected "areal" bone mineral density (TBMD), total lean mass (TLM) and total fat mass (TFM). The average serum Ca, P and AP concentrations over the whole observation period were significantly different between the groups; however, TBMC z-scores for all studied children were statistically similar in all visits. In girls, no between-group differences in height- and weight-controlled TBMC and TBMD or the TBMC/TLM ratio were observed (ANCOVA) and supplementation exerted no effect on these data, suggesting that the total bone mass accrual was not impaired by PTH deficiency in the studied conditions. However, non-supplemented boys showed lower values of the TBMC/TLM ratio than girls, and supplementation normalized these values in direct correlation with the induced improvement in serum P availability to bone. Results indicate that the primary impairment in parathyroid function and bone metabolism indicators in the thyroidectomized children was unrelated to any measurable change in crude bone mass values. However, in boys this condition impaired the TBMC/TLM ratio in such a way that the administered supplementation could normalize it as a function of improved P availability. Girls' skeleton seemed to have been naturally protected against the negative metabolic effect of the studied condition. An estrogen-induced enhancement of the biomechanical impact of muscle contractions on bone mass and structure could not be excluded in this group.

Topics: Absorptiometry, Photon; Adolescent; Alkaline Phosphatase; Body Composition; Bone Density; Calcium; Carcinoma, Papillary; Child; Dihydrotachysterol; Female; Follow-Up Studies; Humans; Hypoparathyroidism; Male; Parathyroid Hormone; Phosphates; Republic of Belarus; Sex Factors; Thyroid Neoplasms; Thyroidectomy

Topics: Anti-Inflammatory Agents; Calcium; Carcinoma, Papillary; Diagnosis, Differential; Dihydrotachysterol; Drug Overdose; Female; Glucocorticoids; Hospitalization; Humans; Hypercalcemia; Hypoparathyroidism; Middle Aged; Postoperative Complications; Prednisone; Prognosis; Thyroid Neoplasms; Thyroidectomy; Thyroxine; Time Factors

Topics: Aged; Brain Diseases; Calcinosis; Calcium; Dihydrotachysterol; Drug Therapy, Combination; Female; Humans; Hypoparathyroidism; Thyroidectomy; Tomography, X-Ray Computed

This report describes a forty-seven-year-old female patient with a complex medical history. She was suffering from an unspecified interstitial lung disease, papillary thyroid carcinoma which had been treated, hypoparathyroidism after thyroidectomy for which she was receiving dihydrotachysterol and calcium, and atrial fibrillation and congestive heart failure as a result of mitral stenosis. Shortly after mitral valve replacement she developed a severe hypercalcemia (serum calcium 5.95 mmol/l) during a febrile illness. At that time anti-tuberculous agents were also being administered for presumed tuberculosis. The possible mechanisms for this severe elevation of the calcium level are discussed. Immobilization, while Paget's bone disease was present, and perhaps enhanced activation of dihydrotachysterol by rifampicin, could have led to increased calcium-release into the circulation. Continuous supplecation of calcium and vitamin D, provoked dehydration and the mechanism of the milk-alkali syndrome also contributed to this extremely high calcium level. It is concluded that hypoparathyroid patients being treated with vitamin D and calcium should be carefully monitored in the case of an intercurrent illness or a change in medication.

Topics: Calcium; Dihydrotachysterol; Female; Heart Valve Prosthesis Implantation; Humans; Hypercalcemia; Hypoparathyroidism; Middle Aged; Osteitis Deformans; Polypharmacy; Postoperative Complications; Proteus Infections; Renal Dialysis; Thyroid Neoplasms; Thyroidectomy; Treatment Outcome; Urinary Tract Infections

Hypoparathyroidism is a rare disease with hypocalcemia as the leading symptom. In adults, hypocalcemia is mainly due to postoperative hypoparathyroidism. Hypoparathyroidism requires lifelong therapy with vitamin D or metabolites. Genuine vitamin D3 (Vigantol) is the most economic treatment of hypoparathyroidism; however, vitamin D3 has a very long biologic half life with the subsequent danger of chronic vitamin D intoxication. Dihydrotachysterol (A.T.10), an analogue of vitamin D, acts similarly and can be used alternatively. 1,25-dihydroxyvitamin D3 (Rocaltrol), the biologically active metabolite of vitamin D3, is very potent, but bears the danger of causing acute intoxication; it has a short half life and is more expensive than vitamin D3. A further metabolite, 1-hydroxy-vitamin D3 (alfacalcidol, Doss, EinsAlpha) is available for therapeutic use. Clinical intervention trials concerning the best therapy and management of hypoparathyroidism are lacking. We therefore surveyed German physicians treating hypoparathyroidism. Furthermore, we carried out a retrospective study of 45 patients treated in our endocrinology department during the last 8 years and examined whether measurement of 25(OH)-vitamin D3 is helpful in managing hypoparathyroidism. The data from 59 children and 270 adults could be completed in the survey. 1,25-dihydroxyvitamin D3 was the only vitamin D agent that was administered in the treatment of children, whereas in adults 52% were treated with dihydrotachysterol, 28% with genuine vitamin D3, and 20% with 1,25-dihydroxyvitamin D3. There was a positive correlation between serum 25(OH)-vitamin D3 levels and administered vitamin D3 doses. In patients treated with vitamin D3, serum calcium levels correlated significantly with serum 25(OH)-vitamin D3 levels whereas they did not correlate with administered calcium doses. Thus: (1) in Germany dihydrotachysterol is preferred for therapy of hypoparathyroidism in adults and (2) measurement of serum 25(OH)-vitamin D3 may be helpful in assessing efficacy of therapy and compliance in patients treated with vitamin D3.

Topics: Adult; Aging; Calcifediol; Calcitriol; Calcium; Child; Cholecalciferol; Dihydrotachysterol; Endocrinology; Germany; Half-Life; Humans; Hypoparathyroidism; Physicians; Retrospective Studies; Surveys and Questionnaires

Topics: Antipsychotic Agents; Brain Damage, Chronic; Calcinosis; Calcium Carbonate; Cognition Disorders; Dihydrotachysterol; Drug Therapy, Combination; Humans; Hypoparathyroidism; Male; Middle Aged; Neuropsychological Tests; Tomography, X-Ray Computed

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

Moderate dietary Na restriction (80 mmol/d for 7 days) during constant Ca intake can reduce high urinary Ca excretion to normal levels in idiopathic hypercalciuria (IH). A similar protocol was used to test its effect in primary hyperparathyroidism (PHPT) and also in hypoparathyroid subjects (HOPT) during treatment with dihydrotachysterol (DHT). Nine subjects with PHPT, 10 with HOPT, and one with pseudo-HOPT were evaluated after Na-restricted (80 mmol/d) and Na-supplemented (200 mmol/d) diets for 7 days each with dietary Ca constant. Na restriction resulted in a decrease in mean urinary 24-hour Ca excretion in PHPT subjects (10.6 v 7.6 mmol/d [424 v 304 mg], P less than 0.0001) and in one pseudo-HOPT subject, similar to the pattern seen previously in IH subjects. In contrast, Na restriction was not accompanied by significant change in Ca excretion in HOPT. There was no change in serum immunoreactive PTH (iPTH) or 1,25(OH)2 vitamin D levels in either group when Na intake was altered. Thus, the presence of parathyroid hormone (PTH) is necessary for sodium-related alterations in urinary Ca to occur. The effect of PTH appears to be "permissive" rather than "active." Dietary Na restriction may have a role in the management of hypercalciuria in mild PHPT cases when parathyroidectomy is contraindicated.

Topics: Calcitriol; Calcium; Diet, Sodium-Restricted; Dihydrotachysterol; Female; Humans; Hyperparathyroidism; Hypoparathyroidism; Male; Parathyroid Diseases; Parathyroid Hormone; Pseudohypoparathyroidism

We treated a hypoparathyroid woman with calcitriol during pregnancy and did not reduce the dosage after delivery. Despite lactation, the serum calcium level increased to 15.4 mg/dL 11 days postpartum. We treated two other hypoparathyroid women during four pregnancies with either calcitriol or dihydrotachysterol. In all five pregnancies, requirements for the vitamin D preparations increased beginning at the 20-28th week of gestation. Hypercalcemia did not occur in the two women who did not breast-feed and in whom we reduced the dose of calcitriol or dihydrotachysterol after delivery. We conclude the following: 1) Calcitriol is effective for treating hypoparathyroidism during pregnancy; 2) the dose usually needs to be increased during the latter half of gestation; 3) the calcitriol dose should be reduced during lactation; and 4) both mother and infant should be monitored to detect hypercalcemia during breast-feeding. We speculate that low serum estrogen levels associated with breast-feeding promote bone resorption and diminish calcitriol needs in lactating hypoparathyroid women.

Topics: Administration, Oral; Adult; Calcitriol; Calcium; Dihydrotachysterol; Female; Humans; Hypoparathyroidism; Hypothyroidism; Lactation; Pregnancy; Pregnancy Complications

Many clinicians continue to prefer dihydrotachysterol (DHT) as the initial vitamin D agent of choice in hypoparathyroidism and renal osteodystrophy because of its long history of efficacy and safety. Assessment of the factors influencing the clinical response to DHT treatment should include measurement of vitamin D metabolite profiles, but investigators have heretofore been unable to measure 1,25(OH)2D because levels have been found to be falsely elevated when employing the chick intestinal cytosol receptor assay. After converting from the chick cytosol receptor assay to the calf thymus receptor assay for measuring 1,25(OH)2D, we did not note falsely elevated levels of 1,25(OH)2D in DHT-treated patients. The design of this study, therefore, was aimed at determining whether or not the calf thymus receptor measured authentic 1,25(OH)2D in such patients. We controlled for the possibility that freezing and thawing or prolonged storage might have either lowered 1,25(OH)2D levels or degraded a metabolite(s) of DHT that would have otherwise been recognized as "1,25(OH)2D" by the calf receptor. Similarly, technical differences between the two assays, source of thymus, and potential interference by other cytosolic proteins were eliminated as causes for the difference between the 1,25(OH)2D levels in the two assays. Our experiments do not provide an explanation for why the thymus receptor does not "see" the interfering metabolite(s) of DHT. This could reflect either a tissue difference or perhaps a species difference. Our results do provide the first opportunity to expand the investigation of the metabolic effects of DHT therapy to include changes in intrinsic 1,25(OH)2D metabolism.

Topics: Biological Assay; Calcitriol; Chronic Kidney Disease-Mineral and Bone Disorder; Dihydrotachysterol; Hypoparathyroidism; Receptors, Calcitriol; Receptors, Steroid; Thymus Gland

Topics: Calcifediol; Calcitriol; Cholecalciferol; Dihydrotachysterol; Drug Resistance; Female; Humans; Hypoparathyroidism; Middle Aged

The neurological manifestations of idiopathic hypoparathyroidism in a father, his son, and his daughter are reported. In all three epilepsy was the first manifestation of the disease. Father and son also showed mental deterioration and striocerebellar symptoms; their CT scans revealed symmetrical calcification in the basal ganglia and dentate nuclei. The extent of this calcification increased during normocalcemia, which was produced by dihydrotachysterol therapy. This indicates that other factors than merely hypocalcemia influence the intracerebral calcifying process. Somatosensory evoked potentials (SSEP) showed an abnormal nonspecific complex, indicating dysfunction of the cortical gray matter. It is suggested that in the evaluation of idiopathic hypoparathyroidism one also must be beware of the possibility of epilepsy, mental deterioration, striocerebellar symptoms, intracerebral calcification and SSEP disturbances.

Topics: Adult; Basal Ganglia Diseases; Brain Diseases; Calcinosis; Cerebellar Diseases; Cerebellar Nuclei; Dihydrotachysterol; Evoked Potentials, Somatosensory; Female; Genes, Dominant; Humans; Hypoparathyroidism; Male; Middle Aged; Radiography

Fourteen patients with pseudohypoparathyroidism, 17 with idiopathic hypoparathyroidism, and 12 with postoperative hypoparathyroidism were treated with vitamin D2, dihydrotachysterol, 1 alpha-hydroxyvitamin D3)1 alpha-OHD3), and 1,25-dihydroxyvitamin D3 for 6-18 months. The optimal maintenance dose or minimum daily dose of 1,25-dihydroxyvitamin D3 to maintain serum calcium at approximately 8.5 mg/100 ml and control all the clinical symptoms was 1.3 +/- 0.16 micrograms/day (mean +/- SE) in pseudohypoparathyroidism, 1.5 +/- 0.18 micrograms/day in idiopathic hypoparathyroidism, and 1.9 +/- 0.50 micrograms/day in postoperative hypoparathyroidism. There was no significant difference in the optimal maintenance dose among the 3 groups. The optimal maintenance dose of 1 alpha-OHD3, however, was 2.0 +/- 0.12 micrograms/day in pseudohypoparathyroidism, significantly lower than that in idiopathic hypoparathyroidism (3.5 +/-0.29 micrograms/day; P less than 0.001) and in postoperative hypoparathyroidism (4.89 +/- 0.54 micrograms/day; P less than 0.001). Significantly lower doses were required in the treatment of idiopathic hypoparathyroidism than in postoperative hypoparathyroidism (P less than 0.05). No significant difference was found in the optimal maintenance dose of dihydrotachysterol and vitamin D2 among the 3 groups. The average pretreatment serum calcium levels and clinical manifestations were indistinguishable among the 3 groups of patients. This suggests that such a difference in the optimal maintenance dose of 1 alpha-OHD3 is ascribed not to the difference in the severity of hypoparathyroidism, but most probably to differences in the pathophysiological processes in pseudohypoparathyroidism and idiopathic or postoperative hypoparathyroidism. The excess parathyroid hormone levels in blood of patients with pseudohypoparathyroidism (and not in other types of hypoparathyroidism) may explain such a difference.

Topics: Adolescent; Adult; Aged; Body Weight; Calcifediol; Calcitriol; Calcium; Dihydrotachysterol; Ergocalciferols; Female; Humans; Hydroxycholecalciferols; Hypoparathyroidism; Male; Middle Aged; Parathyroid Hormone; Phosphorus; Postoperative Complications; Pseudohypoparathyroidism; Vitamin D

Topics: Animals; Calcium; Cat Diseases; Cats; Dihydrotachysterol; Dihydroxycholecalciferols; Dog Diseases; Dogs; Ergocalciferols; Hypoparathyroidism; Vitamin D

Two cases of hypoparathyroidism are described which illustrate part of the spectrum of hormonoplethoric hypoparathyroidism. The first is a case of pseudohypoparathyroidism without the usual associated physical stigmata, and the second a case of hypohyperparathyroidism. The diagnostic importance of hypocalcaemia is emphasized, particularly in the presence of unexplained convulsions. Related hypoparathyroid conditions are discussed.

Topics: Child; Dihydrotachysterol; Female; Humans; Hypoparathyroidism; Pseudohypoparathyroidism

A method for the quantitative estimation of dihydrotachysterol-2 is described using high performance liquid chromatography coupled to an UV monitor. Since radioactive labelled DHT2 is not available, recovery is based on the assumption that dihydrotachysterol-2 and cholecalciferol behave identically during chromatic procedures. Evidence is presented to support this assumption. In patients treated with DHT2 the serum concentrations of DHT2 rose in proportion to the administered dose.

Topics: Chromatography, High Pressure Liquid; Dihydrotachysterol; Female; Humans; Hypoparathyroidism; Male; Osteoporosis

The response of serum 1,25-dihydroxycholecalciferol (1,25-OH2CC) concentration to the administration of parathyroid extract (PTE) was studied in a patient with pseudohypoparathyroidism (PHP) type 1, 3 days after withdrawal of dihydrotachysterol (DHT) treatment. The patient had had a normal serum calcium (Ca), phosphorus (P) and immunoreactive parathyroid hormone (iPTH) level on DHT for 6 years. After PTE administration no rise of the 1,25-OH2CC concentration and no response of urinary cAMP and P were seen.

Topics: Adult; Calcitriol; Cyclic AMP; Dihydrotachysterol; Dihydroxycholecalciferols; Female; Humans; Hydroxycholecalciferols; Hypoparathyroidism; Parathyroid Hormone; Phosphorus; Pseudohypoparathyroidism

Topics: Calcium; Dihydrotachysterol; Ergocalciferols; Humans; Hypoparathyroidism

A patient with idiopathic hypoparathyroidism and a six-year history of a convulsive disorder was treated with 1 alpha-hydroxycholecalciferol and anticonvulsants. The calcemic response to 1 alpha-hydroxycholecalciferol was incomplete. However, normocalcemia was later attained during treatment with dihydrotachysterol. This delayed response suggests that the anticonvulsant therapy interfered with the peripheral effect of the vitamin D metabolite.

Topics: Adolescent; Anticonvulsants; Calcium; Dihydrotachysterol; Drug Interactions; Female; Humans; Hydroxycholecalciferols; Hypoparathyroidism; Phosphorus; Seizures

Topics: Adult; Dihydrotachysterol; Ethinyl Estradiol; Female; Humans; Hypercalcemia; Hypoparathyroidism; Menopause; Substance Withdrawal Syndrome

Topics: Adolescent; Adult; Dihydrotachysterol; Ergocalciferols; Female; Humans; Hydroxycholecalciferols; Hypoparathyroidism; Male; Middle Aged; Pseudohypoparathyroidism

The authors studied the clinical characteristics of primary and post-operative hypoparathyroidism in 39 patients. Laboratory follow-up data were compared under two different treatment programs using either AT 10 or 25 Hydroxycholecalciferol (25 OHCC). Clinical analysis revealed the atypical characteristics of primary hypoparathyroidism. From a therapeutic standpoint, AT 10 and 25 OHCC were equally effective in provoking a return to normal plasma calcium levels, except in complex cases of vitamin D resistance. 25 OHCC proved much easier to manipulate than at 10 and offered a higher security with respect tothe risk of hypercalcemia. The biological activity of 25 OHCC seems to differ from that of AT 10, especially regarding phosphorus metabolism.

Topics: Adult; Calcium; Dihydrotachysterol; Female; Humans; Hydroxycholecalciferols; Hypoparathyroidism; Male; Phosphates; Seasons; Thyroidectomy

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

A retrospective study of the comparative effects of vitamin D, dihydrotachysterol and 1alpha-hydroxyvitamin D3 was undertaken in twenty-eight patients with hypoparathyroidism. The vitamin D compounds restored plasma calcium to the normal range in most patients with comparable actions on the gut, bone and kidney. Although the vitamin D compounds had a direct action on kidney and bone in the absence of PTH, the major action in maintaining plasma calcium was on the gut. Plasma phosphate fell due to a reduction in renal tubular reabsorption. Dihydrotachysterol and 1alpha-hydroxyvitamin D3 had significant practical advantages over vitamin D in their rapid onset of action and their relatively short biological half-life.

Topics: Adolescent; Adult; Aged; Calcium; Dihydrotachysterol; Female; Humans; Hydroxycholecalciferols; Hypoparathyroidism; Male; Middle Aged; Retrospective Studies; Vitamin D

Topics: Adult; Dihydrotachysterol; Female; Humans; Hypoparathyroidism; Male; Middle Aged

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

Patients underlying the permanent endocrine substitution need a particular control and a competent conduction on account of their endangering by intercurrent events. Highly specialised knowledge of the physician and intensive collaboration of the patient from this reciprocity lead to essential aspects of the prophylaxis of the crisis-like exacerbations exhibited in detail. The optimum substitution is supplemented by issuing information and emergency cards. When the patient possesses such cards they will become of decisive importance in an urgent therapy necessary outside the controlling facility.

Topics: Arginine Vasopressin; Brain Edema; Diabetes Insipidus; Dihydrotachysterol; Humans; Hydrocortisone; Hypoparathyroidism; Hypothyroidism; Muscle Cramp; Pituitary Diseases; Thyroid Hormones; Vasopressins

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

This report describes a case of chronic mucocutaneous candidiasis with associated hypoparathyroidism and acutely developed adrenocortical insufficiency. The latter was heralded by hypercalcemia. Upon the institution of cortisol therapy, while still under the effects of a vitamin D analog dihydrotachysterol (DHT), the patient exhibited severe hypocalcemia and tetany. Since calcium intake was minimal during this period of presumed corticosteroid-DHT antagonism, it is suggested that the cortisol disturbed calcium homeostasis by in inhibiting bone calcium resorption.

Topics: Adrenal Insufficiency; Bone Resorption; Calcium; Candidiasis, Cutaneous; Child; Dihydrotachysterol; Female; Homeostasis; Humans; Hydrocortisone; Hypoparathyroidism

In three women intoxication with vitamin D or dihydrotachysterol occurred. Two patients died from complications despite successful lowering of the serum calcium, the third died after a pulmonary embolus during hypercalcaemia 5 months after cessation of vitamin D. Correct observation of the narrow therapeutic range of vitamin D preparations appears most important in the treatment of hypoparathyroidism and other indications. Particular attention should be given to the prophylaxis of over dosage. Apart from regular serum calcium estimations instruction of the patient and relatives as to the dangers and symptoms of intoxication is recommended. The issuing of a therapy identity card would meet these requirements.

Topics: Aged; Biopsy; Bone and Bones; Calcium; Dihydrotachysterol; Dose-Response Relationship, Drug; Female; Humans; Hypercalcemia; Hypoparathyroidism; Middle Aged; Osteoporosis; Pulmonary Embolism; Vitamin D

A 31-year-old man developed chronic secondary hypoparathyroidism after removal of goitre. Asymmetric cerebral oedema occured and a classical picture of pseudo-brain tumour with severe cerebral involvement developed which regressed merely on administration of calcium ions. The patient has remained well for over a year on dihydrotachysterol maintenance.

Topics: Adult; Brain Edema; Calcium; Chronic Disease; Dihydrotachysterol; Humans; Hypoparathyroidism; Male; Postoperative Complications; Pseudotumor Cerebri; Thyroidectomy; Time Factors

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: Aged; Alkaline Phosphatase; Calcium; Cataract; Dementia; Diagnosis, Differential; Dihydrotachysterol; Electrocardiography; Humans; Hypoparathyroidism; Male; Parathyroid Hormone; Parkinson Disease; Phosphates

Topics: Adult; Dihydrotachysterol; Humans; Hypoparathyroidism; Vitamin D

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

Topics: Dihydrotachysterol; Humans; Hypercalcemia; Hypoparathyroidism; Long-Term Care; Time Factors

Topics: Calcium; Creatinine; Depression, Chemical; Dihydrotachysterol; Glomerular Filtration Rate; Humans; Hypoparathyroidism; Hypothyroidism; Intestinal Absorption; Myxedema; Phosphates; Phosphorus; Thyroidectomy; Triiodothyronine

Topics: Adult; Calcium; Calcium Metabolism Disorders; Cataract; Dihydrotachysterol; Edetic Acid; Eye Manifestations; Female; Humans; Hypoparathyroidism; Parathyroid Hormone; Phosphorus Metabolism Disorders; Pseudohypoparathyroidism; Pseudopseudohypoparathyroidism; Water-Electrolyte Balance

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

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

Topics: Adult; Dihydrotachysterol; Female; Humans; Hypoparathyroidism; Male; Middle Aged

Topics: Anti-Bacterial Agents; Blood Urea Nitrogen; Diet Therapy; Dihydrotachysterol; Female; Humans; Hypoparathyroidism; Kidney Calculi; Kidney Failure, Chronic; Middle Aged; Nephrocalcinosis; Time Factors

Topics: Adrenocorticotropic Hormone; Adult; Calcium; Dihydrotachysterol; Female; Humans; Hypoparathyroidism; Male; Middle Aged; Neuromuscular Nondepolarizing Agents; Tetany; Tranquilizing Agents; Vitamin D

Topics: Adult; Biopsy; Calcium; Dihydrotachysterol; Female; Humans; Hypoparathyroidism; Kidney; Middle Aged; Nephrocalcinosis; Thyroidectomy

Topics: Calcium; Calcium Isotopes; Dihydrotachysterol; Humans; Hypoparathyroidism; Hypothyroidism; Myxedema; Thyroidectomy; Triiodothyronine

Topics: Acute Kidney Injury; Calcium; Dihydrotachysterol; Follow-Up Studies; Humans; Hypercalcemia; Hypoparathyroidism; Kidney Diseases; Kidney Function Tests; Urea; Vitamin D

Topics: Adolescent; Adult; Calcium; Cholecalciferol; Dihydrotachysterol; Female; Follow-Up Studies; Humans; Hydroxyproline; Hypoparathyroidism; Kidney Failure, Chronic; Male; Middle Aged; Spectrum Analysis; Thyroidectomy; Vitamin D

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

Topics: Adult; Calcium; Dihydrotachysterol; Female; Humans; Hydroxyproline; Hypoparathyroidism; Kidney Tubules; Middle Aged; Phosphates; Phosphorus

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

Topics: Adult; Calcium; Chronic Disease; Dihydrotachysterol; Humans; Hypoparathyroidism; Male; Phosphates

Topics: Animals; Dihydrotachysterol; Humans; Hypoparathyroidism; Osteomalacia; Rickets; Vitamin D

Topics: Creatinine; Dihydrotachysterol; Diuresis; Fasting; Female; Humans; Hyperparathyroidism; Hyperthyroidism; Hypoparathyroidism; Infusions, Parenteral; Inulin; Kidney Tubules; Methods; Phosphates; Postoperative Complications; Time Factors

Topics: Animals; Calcium; Dihydrotachysterol; Hypoparathyroidism; Male; Parathyroid Glands; Rats

Topics: Animals; Calcium; Dihydrotachysterol; Dogs; Female; Fibrinolytic Agents; Glomerular Filtration Rate; Humans; Hydrogen-Ion Concentration; Hypercalcemia; Hypoparathyroidism; Kidney; Middle Aged; Parathyroid Hormone; Phosphates; Water-Electrolyte Balance

Topics: Adult; Calcium; Dihydrotachysterol; Female; Humans; Hypoparathyroidism; Male; Middle Aged; Sex Factors; Vitamin D

Topics: Adult; Aged; Calcium; Dihydrotachysterol; Ergocalciferols; Female; Humans; Hypoparathyroidism; Male; Middle Aged; Parathyroid Glands; Postoperative Complications; Thyroidectomy

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

Topics: Adolescent; Adult; Calcium; Dihydrotachysterol; Female; Goiter; Humans; Hypoparathyroidism; Sodium; Thyroidectomy

Topics: Adult; Aged; Calcium; Dihydrotachysterol; Female; Humans; Hypercalcemia; Hypoparathyroidism; Magnesium; Middle Aged; Phosphates; Thyroid Function Tests

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

Topics: Dihydrotachysterol; Goiter; Humans; Hypoparathyroidism; Long-Term Care; Male; Middle Aged; Nephrocalcinosis; Thyroid Hormones; Thyroidectomy

Topics: Adolescent; Adrenal Insufficiency; Adult; Child; Child, Preschool; Dihydrotachysterol; Ergocalciferols; Female; Humans; Hypercalcemia; Hypoparathyroidism; Male; Rickets; Vitamin D

Topics: Calcium; Child; Dihydrotachysterol; Electrocardiography; Electromyography; Ergocalciferols; Female; Humans; Hypoparathyroidism; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Seizures; Tetany

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

Topics: Asia, Western; Child; Dental Enamel Hypoplasia; Dihydrotachysterol; Female; Gluconates; Humans; Hypoparathyroidism; Parathyroid Hormone

Topics: Adult; Deafness; Dihydrotachysterol; Ergocalciferols; Female; Humans; Hypoparathyroidism; Ophthalmoplegia; Parathyroid Hormone

Topics: Bone and Bones; Calcium; Calcium Isotopes; Calcium Metabolism Disorders; Dihydrotachysterol; Ergocalciferols; Humans; Hyperparathyroidism; Hypoparathyroidism; Intestine, Small; Intestines; Kidney; Male; Radiometry

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

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

Topics: Calcium; Calcium, Dietary; Dihydrotachysterol; Drug Therapy; Epilepsy, Tonic-Clonic; Humans; Hypoparathyroidism; Psychotic Disorders; Seizures

Topics: Adolescent; Autopsy; Blood; Calcium; Cataract; Cerebrospinal Fluid; Clinical Laboratory Techniques; Dihydrotachysterol; Drug Therapy; Epilepsy; Epilepsy, Tonic-Clonic; Humans; Hypoparathyroidism; Kidney Tubules; Pathology; Phosphorus; Phosphorus Metabolism Disorders; Tetany; Urine; Vitamin D

Topics: Calcium; Calcium, Dietary; Child; Diagnosis; Dihydrotachysterol; Drug Therapy; Ergocalciferols; Humans; Hypoparathyroidism

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

Topics: Dihydrotachysterol; Humans; Hypercalcemia; Hypoparathyroidism; Prednisolone; Prednisone

Topics: Absorption; Calcium, Dietary; Digestion; Dihydrotachysterol; Ergocalciferols; Gastric Juice; Hyperparathyroidism; Hypoparathyroidism; Intestine, Small; Intestines; Rats; Research

Topics: Calcium; Calcium, Dietary; Dihydrotachysterol; Disease; Humans; Hypoparathyroidism; Parathyroid Glands; Phosphorus; Phosphorus, Dietary; Vitamin D

Topics: Carisoprodol; Dihydrotachysterol; Humans; Hyperparathyroidism; Hypoparathyroidism; Meprobamate; Parathyroid Diseases; Parathyroid Glands; Tissue Extracts; Vitamin D; Vitamins

Topics: Animal Experimentation; Animals; Dihydrotachysterol; Estradiol; Hypoparathyroidism; Parathyroid Glands

Topics: Calcium Metabolism Disorders; Cataract; Dihydrotachysterol; Ergocalciferols; Humans; Hypoparathyroidism; Lens, Crystalline; Tetany

Topics: Dihydrotachysterol; Disease; Humans; Hypoparathyroidism; Parathyroid Diseases; Parathyroid Glands; Vitamin D; Vitamins

Topics: Calcium; Calcium, Dietary; Dihydrotachysterol; Disease; Humans; Hypercalciuria; Hypoparathyroidism; Parathyroid Diseases; Parathyroid Glands; Vitamin D; Vitamins

Topics: Dihydrotachysterol; Humans; Hypoparathyroidism; Medical Records; Parathyroid Glands; Tetany; Thyroid Gland; Thyroidectomy; Vitamin D; Vitamins

Topics: Dihydrotachysterol; Disease; Humans; Hypoparathyroidism; Parathyroid Diseases; Parathyroid Glands

Topics: Dihydrotachysterol; Disease; Humans; Hypoparathyroidism; Parathyroid Diseases; Parathyroid Glands; Pseudohypoparathyroidism; Vitamin D; Vitamins