Hypomagnesemia with Increased Metabolism of Parathyroid Hormone and Reduced Responsiveness to Calcitropic Hormones.
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概要
- 論文の詳細を見る
A patient with severe hypomagnesemia due to chronic alcoholism is presented who repeatedly exhibited marked hypocalcemia with a dissociation between radioimmunoassay findings for mid region of parathyroid hormone (PTH-M) and immunoradiometric assay findings of serum intact PTH (PTH-intact). Serum PTH-M was moderately elevated whereas serum PTH-intact was in a low normal range every time when her serum magnesium (Mg) concentration was markedly reduced. There was also a marked reduction in serum osteocalcin concentration. Supplementation of Mg resulted in a sharp increase in serum PTH level with a rapid disappearance of the dissociation between the two immunoassays of PTH. Shortly after serum PTH and 1, 25 (OH) 2D levels reached their peak, serum osteocalcin started to increase, and was elevated into a supranormal level with normalization of serum Ca concentration. Mg is thought to act as a mimic/antagonist of calcium (Ca), and high extracellular Ca is shown to cause an inhibition of secretion with a stimulation of degradation of PTH. Thus, these observations are consistent with the hypothesis that Mg deficiency causes an increase in the metabolism of PTH and a reduction in the secretion of bioactive intact PTH by increasing the sensitivity of parathyoid cells to Ca. In addition, the fact that hypocalcemia disappeared concomitant with a marked increase of serum osteocalcin from undetectable levels suggest that refractoriness of bone to calcitropic hormones is present which plays a significant role in the development of hypocalcemia under hypomagnesemia, and that serum osteocalcin can be a good marker for the assessment of the responsiveness of bone to calcitropic hormones in these patients.(Internal Medicine 31 : 820-824, 1992)
- 社団法人 日本内科学会の論文
著者
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MATSUMOTO Toshio
the First Department of Internal Medicine
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OGATA ETSURO
The First Department of Internal Medicine, University of Tokyo
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OGATA Etsuro
the Fourth Department of Internal Medicine, University of Tokyo Faculty of Medicine
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MORI Seiko
the Fourth Department of Internal Medicine, University of Tokyo Faculty of Medicine
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HARADA Shun-ichi
the Fourth Department of Internal Medicine, University of Tokyo Faculty of Medicine
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OKAZAKI Ryo
the Fourth Department of Internal Medicine, University of Tokyo Faculty of Medicine
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INOUE Daisuke
the Fourth Department of Internal Medicine, University of Tokyo Faculty of Medicine
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MORI Seiko
the First Department of Internal Medicine, Faculty of Medicine, University of Tokyo
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HARADA Shun-ichi
the Fourth Department of Internal Medicine, the University of Tokyo Faculty of Medicine
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MATSUMOTO Toshio
the Fourth Department of Internal Medicine, University of Tokyo Faculty of Medicine
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