Mineral metabolism and calcitriol therapy in idiopathic juvenile osteoporosis
Article Abstract:
Idiopathic juvenile osteoporosis (IJO) is a rare condition that causes a loss of bone mass during childhood. It often occurs just prior to the onset of puberty, and is difficult to diagnose. Symptoms of IJO include bone pain, difficulty walking and bone fractures. In many cases, spontaneous recovery occurs within three to four years. Although the cause of IJO is unknown, the most common feature observed in children with IJO is calcium deficiency and/or vitamin D deficiency. In previous drug trials, calcium supplements, vitamin D, anabolic steroids and calcitonin (a hormone that prevents bone loss) were not effective in altering the outcomes of patients with IJO. In an attempt to identify vitamin and/or mineral deficiencies associated with IJO and develop appropriate therapy, four children with IJO were assessed. When blood samples were analyzed it was found that all four children had normal levels of calcium, phosphate, magnesium and parathyroid hormone. However, three of the children had low levels of vitamin D (1,25-dihydroxyvitamin D). Three of the four patients were treated with calcitriol; the fourth child was not treated because of parental refusal. Treatment with calcitriol reduced the severity of the symptoms and the frequency of bone fractures. Continued treatment for 6 to 12 months resulted in an increase in bone mass (mineralization), and bone mass returned to normal levels in 2 of the 3 treated children. These findings suggest that treatment with calcitriol may be beneficial for some children with IJO. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Diseases of Children
Subject: Health
ISSN: 0002-922X
Year: 1991
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Ketoconazole decreases the serum ionized calcium and 1,25-dihydroxyvitamin D levels in tuberculosis-associated hypercalcemia
Article Abstract:
Ketoconazole may be an effective treatment for children suffering from tuberculosis-associated hypercalcemia. Hypercalcemia is an excess of calcium in the blood that may be caused by abnormal vitamin D metabolism. Two adolescent boys suffering from tuberculosis and hypercalcemia were admitted to the hospital with increased blood levels of 1,25-dihydroxyvitamin D. Blood levels of 1,25-dihydroxyvitamin D decreased in both boys after one week of treatment with three milligrams of ketoconazole per kilogram of body weight every eight hours by mouth. Blood levels of calcium also decreased to normal levels in both boys after treatment. One of the boys experienced side effects from the medicine, including pain in his abdomen, nausea and vomiting, after 12 days of treatment. These symptoms disappeared after the dose of ketoconazole was reduced by half.
Publication Name: American Journal of Diseases of Children
Subject: Health
ISSN: 0002-922X
Year: 1993
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