Vainsel M, Bouillon R
Hôpital Saint-Pierre, Bruxelles.
Rev Med Brux. 1995 Nov;16(5):364-7.
Resistance to vitamin D is known since a long time but was erroneously ascribed to phosphate deficiency (phosphate diabetes or deficiency in tubular phosphate reabsorption). True vitamin D resistance can either be due to lack of the receptor itself or to structural abnormality in the hormone -or DNA-binding site of the receptor whereas in a few cases post-receptor resistance has been documented. In view of the therapeutic consequences, diagnosis of vitamin D resistance is needed in every case of rickets not due to simple vitamin D deficiency. Such cases can be easily recognized by normal 25-hydroxyvitamin D concentration in the presence of biochemical, radiological or/and histological signs of rickets.
对维生素D的抵抗由来已久，但曾被错误地归因于磷酸盐缺乏（磷酸盐性糖尿病或肾小管磷酸盐重吸收缺乏）。真正的维生素D抵抗可能是由于受体本身缺乏，或激素或受体的DNA结合位点存在结构异常，而在少数情况下也有受体后抵抗的记录。鉴于其治疗后果，对于每一例并非由单纯维生素D缺乏引起的佝偻病病例，都需要进行维生素D抵抗的诊断。在存在佝偻病的生化、放射学或/和组织学征象的情况下，通过正常的25-羟基维生素D浓度可以很容易地识别出这类病例。
