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Long‐term therapy of vitamin D‐resistant rickets with 25‐hydroxycholecalciferol
Author(s) -
Puschett Jules B.,
Genel Myron,
Rastegar Asghar,
Anast Constantine,
DeLuca Hector F.,
Friedman Adele
Publication year - 1975
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt1975172202
Subject(s) - rickets , medicine , endocrinology , calcium , vitamin d and neurology , parathyroid hormone , metabolite , alkaline phosphatase , excretion , osteomalacia , vitamin , chemistry , biochemistry , enzyme
The long‐term effects of the vitamin D metabolite, 25‐hydroxycholecalciferol (25‐HCC), were evaluated in 2 children with hypophosphatemic vitamin D‐resistant rickets. Serial total balance studies demonstrated an apparent lack of correlation between the effects of the vitamin on intestinal absorption of calcium and phosphorus and both the onset of healing in 1 of the 2 patients treated with 5,000 to 7,500 u of the metabolite and the absence of demonstrable radiologic improvement in another patient in whom the final dosage was 20,000 u. per day. At first, the metabolite induced a positive calcium balance in both patients resulting largely from a reduction in intestinal calcium excretion. Despite a continued positive calcium balance, 1 of the 2 patients did not demonstrate further healing, while in the other patient healing was noted even when total calcium balance was negative. Serum phosphate levels did not return to normal in either patient, nor was phosphate excretion altered by 25‐HCC. Serum alkaline phosphatase remained elevated in both. Serum immunoassayable parathyroid hormone levels were consistently normal to high‐normal in the 2 patients throughout more than 24 months of observation. No instances of hypercalcemia and only occasional hypercalciuric episodes were noted.