vitamin-d-2 and Osteitis-Fibrosa-Cystica

The available data with regard to the use of calciferol, dihydrotachysterol, and calcifediol in the management of renal insufficiency are reviewed. Very limited data are available with regard to calciferol therapy; with the advent of more active metabolites, the use of calciferol is not warranted. Dihydrotachysterol seems to be effective in the treatment of renal patients with osteitis fibrosa; its low cost makes therapy with this compound a reasonable alternative, although it should not be used in the treatment of patients with liver disease. Calcifediol seems to be effective in patients with osteitis fibrosa; however, limited data on histologic characteristics of bone are available. Detailed prospective studies are necessary to establish the therapeutic benefit of calcifediol.

Topics: Absorption; Calcifediol; Cholecalciferol; Dihydrotachysterol; Ergocalciferols; Humans; Kidney Failure, Chronic; Osteitis Fibrosa Cystica; Structure-Activity Relationship

Topics: Aluminum; Bone Regeneration; Calcium; Calcium Carbonate; Cholecalciferol; Chronic Kidney Disease-Mineral and Bone Disorder; Dihydrotachysterol; Dihydroxycholecalciferols; Ergocalciferols; Humans; Hydroxycholecalciferols; Intestinal Absorption; Osteitis Fibrosa Cystica; Osteomalacia; Parathyroid Glands; Phosphorus; Secretory Rate; Vitamin D

Pseudohypoparathyroidism type 1B (PHP1B) patients have PTH resistance at the renal proximal tubule and develop hypocalcemia and secondary hyperparathyroidism. Hyperparathyroid bone disease also develops in some patients. PHP1B patients are at theoretical risk of developing tertiary hyperparathyroidism.. Patients were studied in a clinical research center.. Five female PHP1B patients presented with hypercalcemia and elevated PTH.. Patients either underwent parathyroidectomy (n = 4) or received cinacalcet (n = 1).. Serum calcium and PTH were serially measured before and after intervention.. Five PHP1B patients developed concomitantly elevated serum calcium and PTH levels (range, 235-864 ng/liter) requiring termination of calcium and vitamin D therapy (time after diagnosis, 21-42 yr; median, 34 yr), consistent with tertiary hyperparathyroidism. Four patients underwent parathyroidectomy with removal of one (n = 2) or two (n = 2) enlarged parathyroid glands. Calcium and vitamin D therapy was reinstituted postoperatively, and at 93-month median follow-up, PTH levels ranged between 56 and 182 (normal, <87) ng/liter. One patient was treated with cinacalcet, resulting in resolution of hypercalcemia.. PHP1B patients are at risk of developing tertiary hyperparathyroidism and/or hyperparathyroid bone disease and should therefore be treated with sufficient doses of calcium and vitamin D to achieve serum calcium and PTH levels within or as close to the normal range as possible. Surgery is the treatment of choice in this setting. Cinacalcet may be a useful alternative in those who do not undergo surgery.

Topics: Adolescent; Age of Onset; Calcitriol; Calcium; Child, Preschool; Disease Progression; Ergocalciferols; Female; Humans; Hyperparathyroidism, Secondary; Hypocalcemia; Male; Middle Aged; Muscular Diseases; Osteitis Fibrosa Cystica; Parathyroid Glands; Parathyroid Hormone; Parathyroidectomy; Pseudohypoparathyroidism; Seizures; Syntaxin 16; Young Adult

A case report where parathyroid bone disease simulates bone metastases. Subsequent treatment of underlying hyperparathyroidism causes a marked improvement in bone disease, leading to a review of the initial diagnosis.

Topics: Adjuvants, Immunologic; Aged; Bone Neoplasms; Calcium; Diagnosis, Differential; Diphosphonates; Ergocalciferols; Female; Homeostasis; Humans; Hydroxycholecalciferols; Hyperparathyroidism; Kidney Neoplasms; Osteitis Fibrosa Cystica; Pain; Radionuclide Imaging; Treatment Outcome

Topics: Adult; Aged; Alkaline Phosphatase; Analgesics; Bicarbonates; Bone Diseases; Calcium; Chronic Kidney Disease-Mineral and Bone Disorder; Ergocalciferols; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Osteitis Fibrosa Cystica; Osteomalacia; Parathyroid Hormone; Substance-Related Disorders

Topics: Alkaline Phosphatase; Biopsy; Bone Resorption; Calcium; Calcium Isotopes; Chronic Disease; Dihydrotachysterol; Ergocalciferols; Glomerulonephritis; Humans; Hyperparathyroidism, Secondary; Intestinal Absorption; Nephritis; Osteitis Fibrosa Cystica; Renal Dialysis

Topics: Adolescent; Alkaline Phosphatase; Bone and Bones; Calcium; Ergocalciferols; Humans; Kidney; Male; Osteitis Fibrosa Cystica; Parathyroid Hormone; Phosphorus; Pseudohypoparathyroidism; Radiography

Topics: Alkaline Phosphatase; Animals; Calcium; Cholecalciferol; Diet; Ergocalciferols; Female; Male; Monkey Diseases; Osteitis Fibrosa Cystica; Phosphorus

Topics: Alkaline Phosphatase; Calcium; Calcium Metabolism Disorders; Calcium, Dietary; Ergocalciferols; Hypoparathyroidism; Inulin; Kidney Tubules; Osteitis Fibrosa Cystica; Parathyroid Hormone; Pharmacology; Phosphorus; Pseudohypoparathyroidism; Rats; Urine

Topics: Alkalies; Aluminum; Bicarbonates; Blood Chemical Analysis; Bone Diseases; Calcium; Ergocalciferols; Humans; Kidney Diseases; Kidney Failure, Chronic; Osteitis Fibrosa Cystica; Osteomalacia

Topics: Calcium; Child; Diagnosis, Differential; Dihydrotachysterol; Ergocalciferols; Exostoses; Humans; Hyperparathyroidism; Myositis Ossificans; Osteitis Fibrosa Cystica; Parathyroid Glands; Pathology; Pseudohypoparathyroidism; Pseudopseudohypoparathyroidism; Turner Syndrome