Skip to main content
PMC home page
British Medical Journal logoLink to British Medical Journal
. 1978 Jan 14;1(6105):75–77. doi: 10.1136/bmj.1.6105.75

Parenteral 1,25-dihydroxycholecalciferol in hepatic osteomalacia.

R G Long, Z Varghese, E A Meinhard, R K Skinner, M R Wills, S Sherlock
PMCID: PMC1602652  PMID: 620204

Abstract

Despite regular long-term parenteral vitamin D2 treatment, four patients with biliary cirrhosis had multiple symptoms of bone disease and bone biopsy specimens showed osteomalacia without osteoporosis. Three patients also had a proximal myopathy. Plasma calcium values (after correction for albumin), phosphorus, magnesium, and serum 25-hydroxy-vitamin D were within normal limits. Treatment with 1,25-dihydroxy-cholecalciferol (1,25-(OH)2D3) relieved symptoms in three of the four patients and improved those in the fourth. Histological examination of bone showed improvement in all four patients, but serum and urinary biochemical changes were not pronounced. We conclude that 1,25-(0H)2D3 treatment has a beneficial effect on bone and muscle in hepatic osteomalacia, either because vitamin D 1-hydroxylation fails in biliary cirrhosis or because hepatic osteomalacia is resistant to vitamin D2 metabolites.

Full text

PDF
75

Selected References

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

  1. ATKINSON M., NORDIN B. E., SHERLOCK S. Malabsorption and bone disease in prolonged obstructive jaundice. Q J Med. 1956 Jul;25(99):299–312. [PubMed] [Google Scholar]
  2. Agnew J. E., Kehayoglou A. K., Holdsworth C. D. Comparison of three isotopic methods for the study of calcium absorption. Gut. 1969 Jul;10(7):590–597. doi: 10.1136/gut.10.7.590. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Ahmed K. Y., Varghese Z., Wills M. R., Meinhard E., Skinner R. K., Baillod R. A., Moorhead J. F. Persistent hypophosphataemia and osteomalacia in dialysis patients not on oral phosphate-binders: Response to dihydrotachysterol therapy. Lancet. 1976 Aug 28;2(7983):439–442. doi: 10.1016/s0140-6736(76)92526-5. [DOI] [PubMed] [Google Scholar]
  4. Ajdukiewicz A. B., Agnew J. E., Byers P. D., Wills M. R., Sherlock S. The relief of bone pain in primary biliary cirrhosis with calcium infusions. Gut. 1974 Oct;15(10):788–793. doi: 10.1136/gut.15.10.788. [DOI] [PMC free article] [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. Henderson R. G., Russell R. G., Ledingham J. G., Smith R., Oliver D. O., Walton R. J., Small D. G., Preston C., Warner G. T. Effects of 1,25-dihydroxycholecalciferol on calcium absorption, muscle weakness, and bone disease in chronic renal failure. Lancet. 1974 Mar 9;1(7854):379–384. doi: 10.1016/s0140-6736(74)93149-3. [DOI] [PubMed] [Google Scholar]
  7. Kehayoglou A. K., Holdsworth C. D., Agnew J. E., Whelton M. J., Sherlock S. Bone disease and calcium absorption in primary biliary cirrhosis with special reference to vitamin-D therapy. Lancet. 1968 Apr 6;1(7545):715–718. doi: 10.1016/s0140-6736(68)92164-8. [DOI] [PubMed] [Google Scholar]
  8. Omdahl J. L., DeLuca H. F. Regulation of vitamin D metabolism and function. Physiol Rev. 1973 Apr;53(2):327–372. doi: 10.1152/physrev.1973.53.2.327. [DOI] [PubMed] [Google Scholar]
  9. Payne R. B., Little A. J., Williams R. B., Milner J. R. Interpretation of serum calcium in patients with abnormal serum proteins. Br Med J. 1973 Dec 15;4(5893):643–646. doi: 10.1136/bmj.4.5893.643. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. 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]
  11. Tripp E. J., MacKay E. H. Silver staining of bone prior to decalcification for quantitative determination of osteoid in sections. Stain Technol. 1972 May;47(3):129–136. doi: 10.3109/10520297209116467. [DOI] [PubMed] [Google Scholar]
  12. Varghese Z., Moorhead J. F., Tatler G. L., Baillod R. A., Wills M. R. Plasma hydroxyproline in renal osteodystrophy. Proc Eur Dial Transplant Assoc. 1973;10(0):187–196. [PubMed] [Google Scholar]
  13. 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 British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES