Skip to main content
PMC home page
Gut logoLink to Gut
. 1979 Feb;20(2):133–136. doi: 10.1136/gut.20.2.133

Treatment of osteomalacia associated with primary biliary cirrhosis with parenteral vitamin D2 or oral 25-hydroxyvitamin D3.

J E Compston, L W Horton, R P Thompson
PMCID: PMC1419456  PMID: 311747

Abstract

The histological and biochemical response of osteomalacia has been studied in four patients with primary biliary cirrhosis, who were treated with oral 25-hydroxyvitamin D3, 50 microgram daily, or intramuscular vitamin D2, 150,000 units once weekly, for five to 12 months. All patients showed complete histological healing of osteomalacia, despite rapidly deteriorating liver function in three. Plasma 25-hydroxyvitamin D concentrations were low in all patients before treatment, but became normal during either vitamin therapy. Serum calcium and phosphate levels, and urinary calcium excretion were not always reliable in predicting the histological response to treatment. Serum alkaline phosphatase activity decreased in all patients during vitamin D therapy. We conclude that both high-dose parenteral vitamin D2 and oral 25-hydroxyvitamin D3 may be effective in healing osteomalacia associated with primary biliary cirrhosis. Measurement of plasma 25-hydroxyvitamin D levels during vitamin D therapy provides useful information about 25-hydroxylation of the parent vitamin and intestinal absorption of orally administered 25-hydroxyvitamin D3.

Full text

PDF
134

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arnaud S. B., Goldsmith R. S., Lambert P. W., Go V. L. 25-Hydroxyvitamin D3: evidence of an enterohepatic circulation in man. Proc Soc Exp Biol Med. 1975 Jun;149(2):570–572. doi: 10.3181/00379727-149-38853. [DOI] [PubMed] [Google Scholar]
  2. BORDIER P., MATRAJT H., MIRAVET L., HIOCO D. MESURE HISTOLOGIQUE DE LA MASSE ET DE LA R'ESORPTION DES TRAV'EES OSSEUSES. Pathol Biol. 1964 Dec;12:1238–1243. [PubMed] [Google Scholar]
  3. Berry E. M., Gupta M. M., Turner S. J., Burns R. R. Variation in plasma calcium with induced changes in plasma specific gravity, total protein, and albumin. Br Med J. 1973 Dec 15;4(5893):640–643. doi: 10.1136/bmj.4.5893.640. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Compston J. E., Ayers A. B., Horton L. W., Tighe J. R., Creamer B. Osteomalacia after small-intestinal resection. Lancet. 1978 Jan 7;1(8054):9–12. doi: 10.1016/s0140-6736(78)90358-6. [DOI] [PubMed] [Google Scholar]
  5. Compston J. E., Thompson R. P. Intestinal absorption of 25-hydroxyvitamin D and osteomalacia in primary biliary cirrhosis. Lancet. 1977 Apr 2;1(8014):721–724. doi: 10.1016/s0140-6736(77)92167-5. [DOI] [PubMed] [Google Scholar]
  6. Edelstein S., Charman M., Lawson D. E., Kodicek E. Competitive protein-binding assay for 25-hydroxycholecalciferol. Clin Sci Mol Med. 1974 Feb;46(2):231–240. doi: 10.1042/cs0460231. [DOI] [PubMed] [Google Scholar]
  7. Fraser D. R., Kodicek E. Unique biosynthesis by kidney of a biological active vitamin D metabolite. Nature. 1970 Nov 21;228(5273):764–766. doi: 10.1038/228764a0. [DOI] [PubMed] [Google Scholar]
  8. Holick M. F., Schnoes H. K., DeLuca H. F., Suda T., Cousins R. J. Isolation and identification of 1,25-dihydroxycholecalciferol. A metabolite of vitamin D active in intestine. Biochemistry. 1971 Jul 6;10(14):2799–2804. doi: 10.1021/bi00790a023. [DOI] [PubMed] [Google Scholar]
  9. Krawitt E. L., Grundman M. J., Mawer E. B. Absorption, hydroxylation, and excretion of vitamin D3 in primary biliary cirrhosis. Lancet. 1977 Dec 17;2(8051):1246–1249. doi: 10.1016/s0140-6736(77)92660-5. [DOI] [PubMed] [Google Scholar]
  10. Long R. G., Meinhard E., Skinner R. K., Varghese Z., Wills M. R., Sherlock S. Clinical, biochemical, and histological studies of osteomalacia, osteoporosis, and parathyroid function in chronic liver disease. Gut. 1978 Feb;19(2):85–90. doi: 10.1136/gut.19.2.85. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Long R. G., Skinner R. K., Wills M. R., Sherlock S. Serum-25-hydroxy-vitamin-D in untreated parenchymal and cholestatic liver disease. Lancet. 1976 Sep 25;2(7987):650–652. doi: 10.1016/s0140-6736(76)92463-6. [DOI] [PubMed] [Google Scholar]
  12. Long R. G., Varghese Z., Meinhard E. A., Skinner R. K., Wills M. R., Sherlock S. Parenteral 1,25-dihydroxycholecalciferol in hepatic osteomalacia. Br Med J. 1978 Jan 14;1(6105):75–77. doi: 10.1136/bmj.1.6105.75. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Ponchon G., Kennan A. L., DeLuca H. F. "Activation" of vitamin D by the liver. J Clin Invest. 1969 Nov;48(11):2032–2037. doi: 10.1172/JCI106168. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. SHERLOCK S. Primary billiary cirrhosis (chronic intrahepatic obstructive jaundice). Gastroenterology. 1959 Nov;37:574–586. [PubMed] [Google Scholar]
  15. Skinner R. K., Sherlock S., Long R. G., Wilis M. R. 25-Hydroxylation of vitamin D in primary biliary cirrhosis. Lancet. 1977 Apr 2;1(8014):720–721. doi: 10.1016/s0140-6736(77)92166-3. [DOI] [PubMed] [Google Scholar]
  16. Thompson G. R., Lewis B., Booth C. C. Absorption of vitamin D3-3H in control subjects and patients with intestinal malabsorption. J Clin Invest. 1966 Jan;45(1):94–102. doi: 10.1172/JCI105327. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Wagonfeld J. B., Nemchausky B. A., Bolt M., Horst J. V., Boyer J. L., Rosenberg I. H. Comparison of vitamin D and 25-hydroxy-vitamin-D in the therapy of primary biliary cirrhosis. Lancet. 1976 Aug 21;2(7982):391–394. doi: 10.1016/s0140-6736(76)92407-7. [DOI] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES