Giraud P, Audran M, Rohmer V, Jallet P, Basle M F, Bregeon C, Bigorgne J C
Department of Rheumatology, CHU Angers, France.
Clin Rheumatol. 1995 May;14(3):287-91. doi: 10.1007/BF02208341.
The diagnosis of pseudohypoparathyroidism with osteitis fibrosa was made in a 51-year-old woman on the basis of hypocalcaemia, elevated plasma PTH (1-84) and blunted cAMP response to hPTH infusion. Radiologically, widespread signs of hyperparathyroidism were observed and quantitative histomorphometry confirmed the increased bone cellular turnover. Treatment with calcitriol (1,25 dihydroxyvitamin D3) induced a dramatic improvement of bone lesions. During treatment PTH (1-84) normalized with high dosage of calcitriol in spite of low or subnormal levels of serum calcium, and subsequently increased for each reduction of calcitriol dosage despite normal calcium levels. Our observations support a major and direct effect of 1,25 dihydroxyvitamin D3 on the regulation of parathyroid secretion of parathyroids glands.
一名51岁女性被诊断为假性甲状旁腺功能减退合并纤维性骨炎，诊断依据为低钙血症、血浆甲状旁腺激素（1-84）升高以及对人甲状旁腺激素输注的环磷酸腺苷反应迟钝。放射学检查发现广泛的甲状旁腺功能亢进迹象，定量组织形态计量学证实骨细胞周转率增加。骨化三醇（1,25-二羟基维生素D3）治疗使骨病变显著改善。治疗期间，尽管血清钙水平低或低于正常水平，但高剂量骨化三醇可使甲状旁腺激素（1-84）恢复正常，随后尽管钙水平正常，但随着骨化三醇剂量的每次减少，甲状旁腺激素（1-84）都会升高。我们的观察结果支持1,25-二羟基维生素D3对甲状旁腺分泌甲状旁腺激素的调节具有主要和直接作用。
