vitamin-d-2 and Adenoma

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: Acidosis, Renal Tubular; Adenoma; Adult; Alkaline Phosphatase; Anuria; Bicarbonates; Bone Diseases; Calcium; Ergocalciferols; Female; Glomerulonephritis; Glycosuria; Humans; Hypercalcemia; Hyperparathyroidism; Hypertension, Renal; Kidney Failure, Chronic; Kidney Transplantation; Parathyroid Glands; Parathyroid Neoplasms; Phosphates; Renal Dialysis; Sodium; Transplantation, Homologous

Calcific uremic arteriolopathy, or calciphylaxis, is a serious and life-threatening complication of end-stage renal disease. Its pathogenesis is not yet fully elucidated and treatment is controversial. In the presence of severe hyperparathyroidism, parathyroidectomy should be considered. We report a case of a woman on maintenance hemodialysis therapy with calciphylaxis and parathyroid adenoma who refused to undergo parathyroidectomy. She was treated successfully with a combination of noncalcium phosphate binders, cinacalcet, and paricalcitol. Subcutaneous plaques disappeared, and the necrotic lesion was healed. Discontinuation of paricalcitol led to an increase in serum parathyroid hormone levels and reappearance of the patient's symptoms, whereas its reintroduction resulted in complete remission of the clinical picture. Paricalcitol, a less calcemic vitamin D analogue, is also a selective vitamin D receptor activator with a number of nonclassic actions (such as inhibition of inflammation and ossification-calcification) that could prove beneficial in cases of calciphylaxis.

Topics: Adenoma; Arterial Occlusive Diseases; Arterioles; Biopsy; Bone Density Conservation Agents; Calcinosis; Ergocalciferols; Female; Follow-Up Studies; Humans; Middle Aged; Parathyroid Neoplasms; Positron-Emission Tomography; Uremia

Because of evidence in experimental animals that prolactin stimulates production of 1,25-dihydroxyvitamin D, we evaluated several indices of calcium metabolism in patients who had hyperprolactinemia due to functioning pituitary adenomas and in normal age-matched controls. Plasma levels of 1,25-dihydroxyvitamin D in hyperprolactinemic patients were in the normal range (15 to 24 pg/ml versus 15 5o 75 pg/ml in controls). Intestinal absorption of calcium, plasma levels of immunoreactive parathyroid hormone, and serum values for calcium, phosphorus, and alkaline phosphatase were similar in patients and controls. We conclude that prolactin probably has no effect on plasma 1,25-dihydroxyvitamin D levels or calcium metabolism in man.

Topics: Adenoma; Adult; Calcium; Cholecalciferol; Dihydroxycholecalciferols; Ergocalciferols; Female; Humans; Hydroxycholecalciferols; Intestinal Absorption; Pituitary Neoplasms; Pregnancy; Prolactin

Topics: Adenoma; Adult; Alkaline Phosphatase; Calcium; Cardiomegaly; Cardiomyopathies; Ergocalciferols; Female; Humans; Hyperparathyroidism; Hypocalcemia; Hypoparathyroidism; Infant, Newborn; Infant, Newborn, Diseases; Parathyroid Hormone; Parathyroid Neoplasms; Perfusion; Phosphorus; Pregnancy; Pregnancy Complications

Topics: Adenoma; Adult; Aged; Calcium; Carcinoma, Papillary; Creatinine; Ergocalciferols; Female; Humans; Hypercalcemia; Hypoparathyroidism; Parathyroid Neoplasms; Pharmaceutical Vehicles; Postoperative Complications; Stimulation, Chemical; Thyroid Neoplasms; Thyroidectomy

Topics: Adenoma; Adult; Bone Resorption; Calcium; Ergocalciferols; Female; Hand; Humans; Hyperparathyroidism; Hyperthyroidism; Hypocalcemia; Osteoclasts; Parathyroid Neoplasms; Pelvis; Postoperative Complications; Radiography; Skull; Tetany

Topics: Adenoma; Bone Cysts; Calcium; Calcium, Dietary; Diagnosis, Differential; Ergocalciferols; Humerus; Lactates; Maxilla; Neoplasms; Parathyroid Neoplasms; Pathology; Radiography, Dental; Surgical Procedures, Operative