Rickets in Infancy and Childhood
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概要
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The studies on two representatives of rickets in childhood are described in this report.<BR>First, plasma levels of 25-hydroxyvitamin D (25-OH-D), serum calcium (Ca), and serum phosphorus (P) were measured in infantile rickets. Mean plasma level of 25-OH-D in rickets group was 13.1±5.7 (S. D.) ng/m<I>l</I> (n=36) which was not significantly lower than that in controls. In rickets group, serum Ca and P were within normal limits, though serum alkaline phosphatase increased significantly. In conclusion, rickets in low birth weight infants is not absolutely due to vitamin D deficiency. Our study suggests that the increase of requirement for vitamin D in low birth weight infants results in relative vitamin D deficiency. Second, clinical effects of massive doses of 1α-hydroxyvitamin D<SUB>3</SUB> (1α-OH-D<SUB>3</SUB>) in patients with hypophosphatemic vitamin D resistant rickets (HVDRR) are shown in the latter half of this report.<BR>Plasma level of 1, 25-(OH) <SUB>2</SUB>-D in patient T. H. increased from 22.5pg/m<I>l</I> to 80.4 pg/m<I>l</I> 2months after administration of 5μg/day of 1α-OH-D3. Plasma level of 1, 25-(OH) <SUB>2</SUB>-D in patient N. K. was 96pg/m<SUB>l</SUB> 3 months after therapy with 1α-OH-D<SUB>3</SUB> at the dose level of 24μg/day.<BR>Plasma level of 1, 25-(OH) <SUB>2</SUB>-D in patient M. Y. was 60pg/m<I>l</I>2 months after therapy at dose level of 16μg/day. Our data demonstrated that plasma levels of 1, 25-(OH) <SUB>2</SUB>D were relatively low in these patients even after administration of massive doses of 1α-OH-D<SUB>3</SUB>. The present study suggests that the metabolism of 1, 25-(OH) <SUB>2</SUB>-D is accelerated in patients with HVDRR (Seino, in press). In two patients there was a rise in fasting serum phosphate associated with an increase in tubular reabsorption of phosphate.
- 社団法人 日本内分泌学会の論文
著者
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Seino Yoshiki
Department Of Pediatrics
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Ishida Makoto
Department Of Applied Chemistry & Biochemistry Faculty Of Engineering Kumamoto University
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SHIMOTSUJI Tsunesuke
Department of Pediatrics, Minoh City Hospital
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Yabuuchi Hyakuji
Department Of Pediatrics Osaka Univer-ity Hospital
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ISHII TSUNEYASU
Department of Pediatrics, Osaka University Hospital
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Shimotsuji Tsunesuke
Department Of Pediatrics Minoh City Hospital
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ISHIDA MAKOTO
Department of Pediatrics, Osaka University Hospital
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SEINO YOSHIKI
Department of Pediatrics, Osaka University Hospital
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YABUUCHI HYAKUJI
Department of Pediatrics, Osaka University Hospital
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