dihydrotachysterol and Postoperative-Complications

Topics: Adult; Age Factors; Calcinosis; Child, Preschool; Dihydrotachysterol; Humans; Hypercalcemia; Hyperparathyroidism, Secondary; Hyperplasia; Kidney Failure, Chronic; Kidney Transplantation; Parathyroid Glands; Parathyroid Hormone; Postoperative Complications; Preoperative Care; Pruritus; Transplantation, Homologous; Vitamin D

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

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

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

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

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

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

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

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