Bell R D, Pak C Y, Zerwekh J, Barilla D E, Vasko M
Ann Neurol. 1979 Apr;5(4):374-8. doi: 10.1002/ana.410050411.
Calcium and vitamin D metabolism were evaluated in 5 adult epileptic patients before and during treatment with phenytoin. Significant decreases occurred in serum concentrations of calcium, albumin, and 25-hydroxy-cholecalciferol. The decreases in serum calcium paralleled those in serum albumin. Significant increases occurred in serum alkaline phosphatase and 1 alpha, 25-dihydroxycholecalciferol, in urinary hydroxyproline, and in the fractional gastrointestinal absorption of calcium. Urinary cyclic adenosine monophosphate and serum parathyroid hormone did not change. The results suggest that the bone disease resulting from phenytoin therapy may be associated with a deficiency of 25-hydroxycholecalciferol and not of 1 alpha, 25-dihydroxycholecalciferol, and that reduced gastrointestinal absorption of calcium or changes in parathyroid function may not be necessary for the development of bone disease.
对5名成年癫痫患者在苯妥英治疗前和治疗期间的钙和维生素D代谢进行了评估。血清钙、白蛋白和25-羟胆钙化醇的浓度显著降低。血清钙的降低与血清白蛋白的降低平行。血清碱性磷酸酶、1α,25-二羟胆钙化醇、尿羟脯氨酸以及钙的胃肠道吸收分数显著增加。尿环磷酸腺苷和血清甲状旁腺激素未发生变化。结果表明，苯妥英治疗导致的骨病可能与25-羟胆钙化醇缺乏有关，而非1α,25-二羟胆钙化醇缺乏，并且钙的胃肠道吸收减少或甲状旁腺功能改变可能不是骨病发生的必要条件。
