OCCULT MALABSORPTION CAUSING OSTEITIS FIBROSA CYSTICA

1962 ◽  
Vol 40 (4) ◽  
pp. 481-492
Author(s):  
J. G. Devlin ◽  
D. K. O'Donovan
Keyword(s):  
Vitamin D ◽  
Iron Absorption ◽  
Calcium Absorption ◽  
Calcium Balance ◽  
Gluten Free ◽  
Osteitis Fibrosa Cystica ◽  
Mucosal Atrophy ◽  
Cystic Changes ◽  
Calcium Malabsorption ◽  
Radiological Examinations

ABSTRACT A case is reported of intermittent hypercalcaemia, hypophosphataemia and severe skeletal rarefaction with cystic changes. An occult calcium malabsorption was found. Fat, triolein and iron absorption and radiological examinations were normal. There was gross intestinal mucosal atrophy. She was shown to be in a state of negative calcium balance and this was reversed by vitamin D. A gluten-free diet also improved calcium absorption. It is postulated that the patient had severe secondary hyperparathyroidism as the skeleton reverted to normal after six months of medical treatment.

Calcium Malabsorption in Elderly Women with Vertebral Fractures: Evidence for Resistance to the Action of Vitamin D Metabolites on the Bowel

1984 ◽  
Vol 66 (1) ◽  
pp. 103-107 ◽  
Author(s):  
R. M. Francis ◽  
M. Peacock ◽  
G. A. Taylor ◽  
J. H. Storer ◽  
B. E. C. Nordin
Keyword(s):  
Vitamin D ◽  
Vertebral Fractures ◽  
Calcium Absorption ◽  
Elderly Women ◽  
Vitamin D Metabolites ◽  
Hydroxyvitamin D ◽  
Dihydroxyvitamin D ◽  
Significant Difference ◽  
Before And After ◽  
Calcium Malabsorption

1. Radio-calcium absorption, plasma 25-hydroxyvitamin D [25-(OH)D] and 1,25-dihydroxyvitamin D [1,25-(OH)2D] concentrations were measured in 19 elderly women with, and 21 without, vertebral fractures, before and after treatment with 25-hydroxyvitamin D3 [25-(OH)D3], to establish whether malabsorption of calcium in elderly women with vertebral fractures has a cause different from that in elderly women without vertebral fractures. 2. Malabsorption of calcium and low plasma 25-(OH)D and 1,25-(OH)2D concentrations were common in both groups of women but there was no significant difference in these variables between the two groups. 3. After treatment with 40 μg of 25-(OH)D3 daily for 7 days, there was a significant increase in plasma 25-(OH)D and 1,25-(OH)2D in both groups of women, but radio-calcium absorption increased significantly only in the group without vertebral fractures. 4. Elderly women with vertebral fractures have malabsorption of calcium which is resistant to the action of vitamin D metabolites at concentrations which correct calcium malabsorption in elderly women without vertebral fractures.

Roux-en-Y gastric bypass surgery reduces bone mineral density and induces metabolic acidosis in rats

2013 ◽  
Vol 305 (9) ◽  
pp. R999-R1009 ◽  
Author(s):  
Kathrin Abegg ◽  
Nicole Gehring ◽  
Carsten A. Wagner ◽  
Annette Liesegang ◽  
Marc Schiesser ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Gastric Bypass ◽  
Metabolic Acidosis ◽  
Bone Loss ◽  
Bone Mineral ◽  
Calcium Absorption ◽  
Sham Operation ◽  
Mineral Density ◽  
Calcium Malabsorption

Roux-en-Y gastric bypass (RYGB) surgery leads to bone loss in humans, which may be caused by vitamin D and calcium malabsorption and subsequent secondary hyperparathyroidism. However, because these conditions occur frequently in obese people, it is unclear whether they are the primary causes of bone loss after RYGB. To determine the contribution of calcium and vitamin D malabsorption to bone loss in a rat RYGB model, adult male Wistar rats were randomized for RYGB surgery, sham-operation–ad libitum fed, or sham-operation–body weight-matched. Bone mineral density, calcium and phosphorus balance, acid-base status, and markers of bone turnover were assessed at different time points for 14 wk after surgery. Bone mineral density decreased for several weeks after RYGB. Intestinal calcium absorption was reduced early after surgery, but plasma calcium and parathyroid hormone levels were normal. 25-hydroxyvitamin D levels decreased, while levels of active 1,25-dihydroxyvitamin D increased after surgery. RYGB rats displayed metabolic acidosis due to increased plasma lactate levels and increased urinary calcium loss throughout the study. These results suggest that initial calcium malabsorption may play a key role in bone loss early after RYGB in rats, but other factors, including chronic metabolic acidosis, contribute to insufficient bone restoration after normalization of intestinal calcium absorption. Secondary hyperparathyroidism is not involved in postoperative bone loss. Upregulated vitamin D activation may compensate for any vitamin D malabsorption.

Measurement of Oral Calcium Absorption from the Gut by External Isotope Counting

1971 ◽  
Vol 57 (2) ◽  
pp. 88-91
Author(s):  
Murdoch A. Macleod
Keyword(s):  
Vitamin D ◽  
Renal Failure ◽  
Calcium Metabolism ◽  
Calcium Absorption ◽  
Normal Subjects ◽  
Intestinal Calcium Absorption ◽  
Calcium Balance ◽  
Oral Calcium ◽  
Absorption Current ◽  
Reliable Methods

AbstractAmong the factors which regulate normal gastro-intestinal calcium absorption, current thought recognises calcium intake, vitamin D and parathyroid hormone as playing an important part. It is well documented that gastro-intestinal calcium absorption is reduced in states of malabsorption, hypoparathyroidism and in patients with chronic renal failure, and raised in states of hyperparathyroidism, urolithiasis and idiopathic hypercalcuria.Difficulties inherent in classic calcium-balance techniques have prompted a search for more practical and reliable methods of measuring the degree of impairment of calcium absorption. This paper describes a study of intestinal calcium absorption in 10 normal subjects and four patients, with various disorders of calcium metabolism, using an external radio-isotope counting technique.

scholarly journals Serum parathyroid hormone (PTH) levels in smokers and non-smokers. The fifth Tromsø study

2005 ◽  
Vol 152 (1) ◽  
pp. 39-45 ◽  
Author(s):  
R Jorde ◽  
F Saleh ◽  
Y Figenschau ◽  
E Kamycheva ◽  
E Haug ◽  
...  
Keyword(s):  
Vitamin D ◽  
Renal Excretion ◽  
Calcium Absorption ◽  
Serum Levels ◽  
Calcium Balance ◽  
Serum Parathyroid Hormone ◽  
Lower Serum ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Serum Pth

Objective: Smoking is associated with reduced bone density and calcium absorption, and reduced serum levels of vitamin D. A compensatory increase in serum parathyroid hormone (PTH) would therefore be expected as a result of an altered calcium balance. However, reports on PTH levels in smokers are conflicting. As serum PTH levels give important information on the calcium balance, the PTH levels in smokers are of interest. Subjects and methods: In the fifth Tromsø study, smoking status was recorded and serum PTH measured in 7896 subjects. Intakes of calcium and vitamin D were evaluated with a food-frequency questionnaire. In a follow-up study on 205 subjects, serum 25-hydroxyvitamin D, calcium absorption, and renal excretion of calcium were measured in addition. Results: The serum PTH levels were significantly lower in smokers than non-smokers (3.1±1.4 vs 3.6±1.9 pmol/l in males; 3.1±1.5 vs 3.6±1.8 pmol/l in females (P < 0.001) after correcting for confounding variables, linear regression). In the smokers, there was no association between number of cigarettes smoked and serum PTH. One year after quitting smoking, serum PTH levels were similar to those of people who had never smoked. The smokers had significantly lower intake of vitamin D, lower serum levels of 25-hydroxyvitamin D and lower calcium absorption. The intake of calcium and the renal excretion of calcium were similar to that in non-smokers. Conclusions: Smokers have lower serum PTH levels than non-smokers. This cannot be explained by the predictors of serum PTH measured in our study.

Studies of Calcium Absorption in Man Using a CD-2 Whole-Body Counter

1977 ◽  
Vol 16 (04) ◽  
pp. 163-167
Author(s):  
K. Bakos ◽  
Věra Wernischová
Keyword(s):  
Calcium Absorption ◽  
Whole Body ◽  
Control Group ◽  
Absorption Process ◽  
Whole Body Counter ◽  
Absorption Studies ◽  
Body Counting ◽  
Calcium Load ◽  
Calcium Malabsorption ◽  
Whole Body Counting

SummaryWhole-body counting makes an important contribution of radioisotope techniques to ȁEin vivo“ absorption studies, in comparison with other methods. In a large number of subjects, the method was tested for its usefulness in the diagnosis of calcium malabsorption. The effects of drugs, of the calcium load in the gut and of the whole-body content of calcium on the absorption process were studied in a control group.

scholarly journals Nutritional Status in Spanish Adults with Celiac Disease Following a Long-Term Gluten-Free Diet Is Similar to Non-Celiac

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1626
Author(s):  
Catalina Ballestero-Fernández ◽  
Gregorio Varela-Moreiras ◽  
Natalia Úbeda ◽  
Elena Alonso-Aperte
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Celiac Disease ◽  
Vitamin E ◽  
Nutritional Status ◽  
Bone Mineral ◽  
Biochemical Parameters ◽  
Gluten Free ◽  
Mineral Density

The only available treatment for celiac disease is life-long gluten exclusion. We conducted a cross-sectional age- and gender-matched study in 64 celiac adults on a long-term (>1 year) gluten-free diet and 74 non-celiac volunteers from Spain, using dietary, anthropometric, and biochemical parameters, as well as assessing bone mineral density and physical activity. Celiac adults had deficient intake (below 2/3 of the recommended intake) for folates, vitamin E, and iodine and low intake of calcium (below 80% of the recommended intake). Iron intake was also below 2/3 of the recommended intake in celiac women. Vitamin D intake was extremely low, and 34% of celiac patients had moderately deficient plasma levels. According to bone mineral density, celiac women may be more prone to osteopenia and osteoporosis. However, we found a perfectly analogous nutritional status scenario in celiac as compared to healthy volunteers, with the dietary deviations found being similar to those of the Spanish population, i.e., both groups followed a high-lipid, high-protein, and low-carbohydrate diet. Values for biochemical parameters were found within the reference ranges. Celiac disease had no influence on body weight, but body fat in celiac patients tended to be higher. According to our results, vitamin D, calcium, folates, vitamin E, iodine, and iron nutritional status should be specifically assessed and monitored in the celiac population.

scholarly journals AB0622 WHEN OSTEOPOROSIS, COELIAC DISEASE AND MULTIPLE MYELOMA CO-EXIST

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1345.1-1345
Author(s):  
S. Khalid ◽  
R. Smith
Keyword(s):  
Bone Mineral Density ◽  
Multiple Myeloma ◽  
Vitamin D ◽  
Coeliac Disease ◽  
Secondary Osteoporosis ◽  
Gluten Free ◽  
Z Score ◽  
Mineral Density ◽  
History Of ◽  
Secondary Causes

Background:Secondary causes of bone loss are sometimes overlooked in patients who are diagnosed as having osteoporosis. This is especially true if more than one risk factor for secondary osteoporosis is present, with clinicians focusing on the more common cause. Here we present a case of secondary osteoporosis caused by coeliac disease and multiple myeloma.Objectives:Secondary osteoporosis should be suspected in patients with very low bone mineral density and those with no obvious risk factors. Comprehensive examination and investigations must be done to look for all secondary causes because sometimes, as seen in our patient, you may find more than one.Methods:A 74 year old gentleman presented to the rheumatology clinic for assessment of osteoporosis. He had been recently diagnosed with coeliac disease. DXA scan showed a T score of -3.5 at the lumbar spine, -2.5 at the left hip and a low Z score of -2.9. He had not sustained any fractures in the past. There was no history of corticosteroid exposure and no parental history of hip fracture or osteoporosis. He drank up to 21 units of alcohol a week and was an ex-smoker. He was managing a gluten-free diet. His testosterone and vitamin D levels were normal. Serum electrophoresis, done as part of the osteoporosis workup, revealed a diagnosis of multiple myeloma. He then developed back pain and given his new diagnosis of myeloma, prompt investigations were carried out. A skeletal survey showed T7 fracture and a subsequent MRI scan showed impending cord compression, which were treated successfully with radiotherapy. He underwent chemotherapy and autologous stem cell transplantation for his myeloma.He recently had an OGD following one week post gluten rechallenge after an established gluten free diet. His biopsy shows no evidence of coeliac disease. Interestingly, the stem cell transplantation did not only treat our patient’s myeloma, but also his coeliac disease.Results:Z-score is a useful indicator of possible secondary osteoporosis. A score of −2.0 or less is below the expected range for age and should prompt careful scrutiny for an underlying cause.Coeliac disease is a gluten-sensitive enteropathy and a known cause for secondary osteoporosis. It likely causes bone loss by secondary hyperparathyroidism from vitamin D deficiency. Multiple myeloma is a disease of aging adults resulting in osteolytic and/or osteoporotic bone disease through increased bone resorption and decreased bone formation from pro-inflammatory cytokines. While coeliac disease patients are at increased risk of all malignancies, association with multiple myeloma is rare, but has been described.Conclusion:This case highlights the importance of evaluating for secondary causes for low bone mineral density and often, one may find more than one contributory factor. It also shows that a Z-score of −2.0 could help identify patients with a secondary cause for osteoporosis and those who would especially benefit from a thorough history and examination.References:[1]Sahin, Idris & Demir, Cengiz & Alay, Murat & Eminbeyli, Lokman. (2011). The Patient Presenting with Renal Failure Due to Multiple Myeloma Associated with Celiac Disease: Case Report. UHOD - Uluslararasi Hematoloji-Onkoloji Dergisi. 21. 10.4999/uhod.09087.[2]İpek, Belkiz & Aksungar, Fehime & Tiftikci, Arzu & Coskun, Abdurrahman & Serteser, Mustafa & Unsal, Ibrahim. (2016). A rare association: celiac disease and multiple myeloma in an asymptomatic young patient. Turkish Journal of Biochemistry. 41. 10.1515/tjb-2016-0053.[3]Swaminathan K, Flynn R, Garton M, Paterson C, Leese G. Search for secondary osteoporosis: are Z scores useful predictors? Postgrad Med J. 2009 Jan;85(999):38-9. doi: 10.1136/pgmj.2007.065748. PMID: 19240287.Disclosure of Interests:None declared.

Calcium absorption and vitamin D in the chick

1951 ◽  
Vol 34 (1) ◽  
pp. 105-111 ◽  
Author(s):  
B.B. Migicovsky ◽  
A.M. Nielson
Keyword(s):  
Vitamin D ◽  
Calcium Absorption
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