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S E Papapoulos

Publications and source records attributed to S E Papapoulos.

142 records · Page 8Linked to original sources
PubMed1980

Comparison of 1,25(OH)2D3 and 24,25(OH)2D3 in the long-term treatment of renal osteodystrophy.

24,25(OH)2D3 has been compared with 1,25(OH)2D3 in the treatment of renal osteodystrophy. Treatment with 24, 25(OH)2D3 2 micrograms/day for 5-7 months was accompanied by deterioration in clinical, biochemical, radiological and histological features of osteodystrophy with no increase in Ca absorption. In contrast, treatment with 1,25(OH)2D3 0.25--1 microgram/day for 6-15 months resulted in rapid improvement in clinical, biochemical, radiological and histological features and a return of Ca absorption to normal. It is concluded that in the dose used 24,25(OH)2D3 alone is not an effective treatment for renal osteodystrophy.

24,25-Dihydroxyvitamin D 3↗
PubMed1979

1, 25-dihydroxycholecalciferol in the pathogenesis of the hypercalcaemia of sarcoidosis.

A 36-year-old man with sarcoidosis had four episodes of hypercalcaemia in seven years, all of them during the summer months. Measurement over three years showed that hypercalcaemia was associated with small seasonal increases in serum-25-hydroxycholecalciferol within the normal range. These changes could be mimicked by the administration of 3000 units of vitamin D3 daily. Serum 1, 25-dihydroxycholecalciferol concentrations ranged between 26--62 pg/ml when serum calcium was normal, but were strikingly high, up to 137 pg/ml, when the patient was hypercalcaemic. These studies show for the first time that hypercalcaemia in sarcoidosis is associated with abnormally high circulating concentrations of 1, 25-dihydroxycholecalciferol, probably as a result of overproduction of this, the hormonal form of vitamin D.

Adult↗
PubMed1979

Measurement of 1,25-dihydroxycholecalciferol in man by radioimmunoassay.

1 alpha, 25-Dihydroxycholecalciferol (1,25-(OH)2D3) has been measured in human serum by radioimmunoassay. The assay uses a high titre antiserum raised in sheep against 1,25-(OH)2D3-25-hemisuccinate, conjugated to bovine serum albumin. The sensitivity of the assay is 10 pg/tube. Other hydroxylated forms of vitamin D3 cross react with the antiserum and are therefore removed from serum extracts by chromatography on Sephadex LH 20 followed by high pressure liquid chromatography. The mean (+/- SEM) serum 1,25-(OH)2D3 concentration for a group of healthy adult subjects was 41 +/- 2.5 pg/ml. None was detected in anephric patients and the concentration was low or undetectable in patients with chronic renal failure.

Adult↗
PubMed1979

Control of hypercalcaemia in thyrotoxicosis.

Two thyrotoxic patients with significant hypercalcaemia are described. The hypercalcaemia failed to suppress with hydrocortisone, propranolol and calcitonin but serum calcium fell rapidly to normal with carbimazole treatment. Both patients were subsequently treated surgically and at operation no evidence of parathyroid disease was found. Thyroid disease must be controlled before co-existing parathyroid disease is diagnosed in hypercalcaemic thyrotoxic patients.

Adult↗
PubMed1978

Studies of hypoparathyroidism and pseudohypoparathyroidism.

Twenty eight hypocalcaemic patients were studied, 14 with primary hypoparathyroidism, nine with pseudohypoparathyroidism and two with hypo-hyperparathyroidism, to characterized the essential features of these disorders. Like tetany, which was present in 12 of the patients, epilepsy was a common symptom, occurring in 13, seven of whom had received anticonvulsants for two to eight years before hypocalcaemia was detected. Differentiation between primary and pseudohypoparathyroidism could not be made with certainty on clinical grounds but confident distinction could be made by measurement of endogenous parathyroid hormone concentrations and by testing for renal resistance to exogenous parathyroid hormone. This was achieved by measurement of the plasma and, in some patients, the urinary cyclic AMP response to an intravenous injection of highly purified bovine parathyroid hormone. These investigations were also valuable in the assessment of the other three hypocalcaemic patients in whom a diagnosis of parathyroid dysfunction would otherwise have been made. In 10 of the patients synthetic 1 alpha-hydroxylated forms of vitamin D were used to establish and maintain normocalcaemia, though their use required careful monitoring.

Adolescent↗
PubMed1977

1-alpha-hydroxycholecalciferol for renal osteodystrophy.

Fourteen patients with renal osteodystrophy were treated for at least one year with 1-alpha-hydroxycholecalciferol (1-alpha-OHD3) in a dose varying from 1 microgram/week to 3 microgram/day. Plasma calcium and inorganic phosphorus concentrations increased significantly. The plasma alkaline phosphatase concentration fell in 11 of the 12 patients in whom it was initially raised and returned to normal in seven. Serum parathyroid hormone concentrations were initially raised in all patients, but they decreased significantly with treatment and became normal in eight patients within one year. The 10 patients with radiological abnormalities showed some improvement. Hypercalcaemia occurred in 11 patients, and necessitated a reduction in the dose of 1-alpha-OHD3 in some. 1-alpha-OHD3 was effective in reducing the biochemical and radiological abnormalities of renal osteodystrophy, but it should be used wtih care, and plasma calcium concentrations should be monitored.

Adolescent↗
PubMed1977

Hyperparathyroidism in chronic renal failure.

The high circulating concentrations of immunoassayable parathyroid hormone observed in chronic renal failure are due to a number of factors. These include altered metabolism of the hormone and also end-organ unresponsiveness which may, indirectly, cause increased secretion of parathyroid hormone. The response of the overactive parathyroid glands to changes in plasma calcium and magnesium is variable and caution is needed in evaluating the suppressibility of parathyroid hormone secretion in acute studies. 1alpha-Hydroxylated derivatives of vitamin D can effectively suppress parathyroid gland overactivity. This effect may not necessarily be medicated through hypercalcaemia and vitamin D metabolites may act directly on the parathyroid glands.

Calcium↗
PubMed1977

1alpha-hydroxyvitamin D3 in the long-term management of hypoparathyroidism and pseudohypoparathyroidism.

Normocalcaemia was restored and maintained in eleven hypoparathyroid and two pseudohypoparathyroid patients treated for up to 36 months with 1alpha-hydroxyvitamin D3. It was found to be a potent compound, maintenance doses ranging from 4 microgram weekly to 2 microgram daily. Supplementary oral calcium was used in acutely and profoundly hypocalcaemic patients but was given to only two patients as part of long-term therapy. Hypercalcaemic episodes occurring during treatment were of short duration and could be controlled by withdrawal of medication alone.

Adult↗
PubMedDate not supplied

Bone mineral density in ambulant, non-steroid treated female patients with rheumatoid arthritis.

Bone mass measurements were performed in a group of 30 ambulant, non-steroid treated female patients with rheumatoid arthritis (RA) of relatively short duration (mean 4.9 years). The bone mineral density (BMD) of the lumbar spine and femoral neck was assessed by dual-energy x-ray absorptiometry (DEXA), and related to parameters of disease activity and severity. Lumbar BMD was within the range of normal while femoral BMD was decreased compared to age-matched controls. BMD values, expressed as the percentage of age-matched healthy controls (BMD%), were positively related to the body mass index and negatively related to the number of swollen joints, the erythrocyte sedimentation rate and the platelet count. No relation was found between the lumbar and femoral bone mass on the one hand and disease duration, number of disease modifying anti-rheumatic drugs ever used, Ritchie articular index, C-reactive protein, functional ability or radiological scores on the other. It is concluded that in ambulant non-steroid treated female RA patients lumbar bone mass as measured with DEXA is within the range of normal, while femoral bone mass is slightly reduced. Both lumbar and femoral bone mass are related to the body mass index and parameters of disease activity.

Absorptiometry, Photon↗