A. Bergans

CORRECTION OF LOW CIRCULATING LEVELS OF 1,25-DIHYDROXYVITAMIN D BY 25-HYDROXYVITAMIN D DURING REVERSAL OF HYPOMAGNESAEMIA

The effect of 25‐hydroxyvitamin D (250HD), given orally during the reversal of hypomagnesaemia, was studied in five patients with hypomagnesaemic hypocalcaemia and low serum levels of 25OHD and 1,25‐dihydroxyvitamin D (1,25(OH)2D). The results were compared to those obtained in five other patients with similar initial levels of magnesium, calcium, 25OHD and 1,25(OH)2D who did not receive 25OHD. Serum levels of 1,25(OH)2D in the ten hypomagnesaemic patients were lower than in ten control subjects with low serum levels of 25OHD. The reversal of hypomagnesaemia was similar in the two groups of patients and elicited a similar increase of circulating iPTH levels. The expected increase of circulating 25OHD was observed in patients supplemented with 25OHD; their circulating 1,25(OH)2D rose within 48 h to normal levels, contrasting with the delayed and poor increase of 1,25(OH)2D in patients receiving no 25OHD. The evolution of serum calcium was however identical in the two groups. Our results suggest that vitamin D deficiency was a significant factor leading to low circulating levels of 1,25(OH)2D in hypomagnesaemic hypocalcaemic patients. The biological consequences of low serum 1,25(OH)2D in these patients remain unclear, but clearly, normal levels of 1,25(OH)2D are not essential for the correction of hypomagnesaemic hypocalcaemia.

Calcium metabolism disturbances in sarcoidosis.

SummarySarcoidosis was confirmed by biopsy in 13 out of 16 patients in which the disease was suspected. Hypercalcemia was present in 4 patients, associated with renal insufficiency; hypercalciuria without hypercalcemia was found in 3 patients with a normal glomerular filtration rate; 9 patients had normal serum and urinary calcium. Circulating 1, 25-dihydroxyvitamin D (l,25(OH), D) was increased in hypercalcemic patients, in spite of renal insufficiency. Corticosteroid treatment rapidly normalized l,25(OH)2D levels in a few days, and corrected hypercalcemia. In one patient, the progressive reduction of prednisolone to 2.5 mg/day was followed by the recurrence of hypercalcemia. One patient exhibited before corticotheraPy a recurrent seasonal hypercalcemia. The absence of calcium metabolism abnormalities in about 50% of our patients could correspond in some cases to inactive sarcoidosis and/or to a low level of 25-hydroxyvitamin D, the precursor of l,25(OH)2D, but remained without explanation in other patie...

Traitement Chronique D’une Naine Hypophysaire Par L’hormone De Croissance Humaine

SummaryA female pituitary dwarf, aged 14 at the initiation of the treatment, has received human growth hormone (6 mg per week) for 40 months. She grew 19.5 cm (0.49 cm per month in average) during that period. Before treatment, her speed of growth was 0.13 cm per month.The effect of the treatment was particularly marked during the first six months, then faded and disappeared completely after two years.The discontinued administration of growth hormone (12 mg per week, two weeks per month) without change in total monthly dosage, was followed by a new growth spurt.The blood level of phosphorus and glucose did not change during treatment, the blood urea level decreased.No sign of sexual maturation appcared.