Catch-up growth in cortisone-treated rats: effects of calcium and vitamin D.
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Biomedical subjects
Publications and source records attributed to D G Barr.
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A girl with the syndrome of thrombocytopenia with absent radius had severe diarrhoea and dehydration relieved by withdrawal of cows' milk and aggravated by its reintroduction on three occasions. Deterioration in gastrointestinal symptoms was associated with haematological relapse with thrombocytopenia, leucocytosis, anaemia, and eosinophilia. There appeared to be a correlation between milk exposure and the haematological and gastrointestinal disturbances. Supporting evidence from published reports for such a correlation is reviewed. Cows' milk protein intolerance may be a factor in precipitating haematological relapse in susceptible infants with radius aplasia. Early withdrawal of cow's milk protein should be tried in thrombocytopenia with absent radius, especially in cases with prominent gastrointestinal upset.
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In an oral calcium-loading test performed on 10 infants with vitamin-D deficiency rickets and low fasting calcium levels, a comparison of results before and after therapy showed that vitamin D raised the serum calcium level at each stage of the test and altered the response so that a more rapid and substantial rise and fall in serum calcium occurred.The effects of vitamin D therapy on newborn infants with hypocalcaemic hyperphosphataemic tetany in another study suggests that these infants should be treated in this way to make them more responsive to oral calcium therapy.
An oral calcium-loading test suitable for infants is described and the usual response defined. In four acute cases of idiopathic hypercalcaemia a high and sustained rise in serum calcium occurred, suggestive of hyperabsorption and consistent with a vitamin-D-like effect. In four further infants with a milder illness suggestive of hypercalcaemia the fasting calcium levels were not grossly raised, but the test produced an exaggerated hypercalcaemic response. In this type of patient the test is more sensitive in the diagnosis of idiopathic hypercalcaemia than isolated measurements of serum calcium, especially if these are taken in the fasting state. Five patients on treatment and three whose treatment had been discontinued (but who subsequently relapsed or made a poor recovery) showed abnormal loading tests at a time when fasting calcium levels were normal. In two cases full recovery from the disease was associated with reversion of the test to normal. The test can therefore be used to indicate activity of the disease and consequently as a guide to therapy. In two cases a persistently abnormal loading test was associated with a poor long-term prognosis.
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