scholarly journals Variations in serum calcium, inorganic phosphorus and magnesium levels due to stage of lactation, season, and age in Ayrshire cows injected with vitamin D3 prior to calving

1970 ◽  
Vol 42 (1) ◽  
pp. 8-20
Author(s):  
Vappu Kossila ◽  
Paavo Niemelä ◽  
Erkki Koskenkorva
Keyword(s):  
Vitamin D ◽  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Inorganic Phosphorus ◽  
Feeding Period ◽  
Phosphorus Level ◽  
Blood Samples ◽  
Grazing Period ◽  
Phosphorus Levels

Blood mineral studies were carried out in the dairy herd of the Viik Experimental Farm, in which parturient paresis has been successfully prevented by intramuscular injections of vitamin D3 (2 X 5 million I.U.). The material consisted of 41 cows from which 207 blood samples had been taken in 1963 and 12 cows (6 controls, 6 vitamin D injected cows) from which 72 blood samples had been taken in 1969. All cows were either dry and pregnant or lactating and nonpregnant. Compared to values obtained during the dry period, the serum calcium level was only slightly lower shortly after calving. The calcium level increased in the vitamin D treated cows during the ascending phase of lactation, whereas both the calcium and inorganic phosphorus levels remained relatively low in the control cows, respectively. The highest mean magnesium levels occurred during the 2nd and 3rd weeks of lactation. The serum calcium level was higher during the grazing period than during the indoor feeding period. Inorganic phosphorus remained at a relatively high level in younger cows during the grazing period, whereas a significant decrease was noted in the phosphorus level of older cows, respectively. The lowest magnesium values were noted in May, i.e. already before the beginning of the pasture season, the concentration increasing towards the end of the grazing period especially in younger cows. As a whole, younger cows had slightly higher mean serum calcium and magnesium levels and significantly higher inorganic phosphorus levels compared to older cows. The effect of age on the inorg. phosphorus level appeared to be more marked in dry cows and during the grazing period than in lactating cows and during the winter feeding period. Special attention has been paid to the blood mineral values of four individual cows suffering from various illnesses during the study period.

Effects of chronic hypocalcaemia on plasma renin activity in man

1980 ◽  
Vol 94 (4) ◽  
pp. 507-510 ◽  
Author(s):  
O. Gedik
Keyword(s):  
Vitamin D ◽  
Plasma Renin Activity ◽  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Plasma Renin ◽  
Control Group ◽  
Blood Samples ◽  
The Mean ◽  
Group 1

Abstract. A study was carried out to investigate the role of serum calcium in the regulation of renin secretion. The subjects for this study comprised of two groups. Group 1 consisted of 10 patients with primary or secondary hypoparathyroidism. Blood samples for basal PRA (plasma renin activity) were drawn at 8 a.m. when the patients were recumbent and on a normal sodium intake. Then all the patients were given a constant diet containing 10 mEq sodium for 4 days and were given 80 mg of Furosemid orally every day. On the morning of the fifth day blood samples were drawn after the patients had been upright for 4 h. These patients were treated with vitamin D2 and when normocalcaemic states were achieved the same study was repeated. Group 2 (control group) consisted of 10 normal, healthy subjects of both sexes. They were prepared for the experiment in the same way as for group 1. In the hypocalcaemic state mean serum calcium level was 5.6 ± 0.3 mg/100 ml. After treatment with vitamin D2, the mean serum calcium level was increased to 9.6 ± 0.1 mg/100 ml (P < 0.001). There was no significant difference in the mean serum sodium and potassium levels in either hypocalcaemia or normocalcaemia. But the mean stimulated PRA (12.12 ± 1.13 ng/ml/h) was found to be decreased in hypocalcaemia compared to in normocalcaemia and in the control group (22.87 ± 1.18 and 23.83 ± 0.86 ng/ml/h, respectively). The difference of means was significant (P < 0.001). There were no significant differences between basal PRA in hypocalcaemic and normocalcaemic state as well as in the control group. (P> 0.5, P > 0.2 and P> 0.5, respectively). Our results indicate that serum calcium plays an important role in the regulation of renin secretion.

scholarly journals Serum calcium level is associated with metabolic syndrome in the general population: FIN-D2D study

2011 ◽  
Vol 165 (3) ◽  
pp. 429-434 ◽  
Author(s):  
J Saltevo ◽  
Leo Niskanen ◽  
Hannu Kautiainen ◽  
Jorma Teittinen ◽  
Heikki Oksa ◽  
...  
Keyword(s):  
Physical Activity ◽  
Metabolic Syndrome ◽  
Vitamin D ◽  
Serum Calcium ◽  
Calcium Intake ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Hdl Cholesterol ◽  
Vitamin D Intake ◽  
Study Population

BackgroundThe aim of this cross-sectional study was to examine the association between serum calcium and the components of metabolic syndrome (MetS).MethodsAs a part of the national prevention program of diabetes in Finland (FIN-D2D), a randomly selected study population of 4500 middle-aged men and women were recruited from three central hospital district areas. Anthropometric measurements were performed by a trained nurse. An oral glucose tolerance test was performed and serum calcium and lipids were measured. We assessed current medications, physical activity, smoking, alcohol consumption, calcium intake, and vitamin D intake. The MetS was defined according to the criteria of the updated National Education Program. The study population consisted of 2896 individuals: 1396 men (62% of invited individuals) and 1500 women (66.7% of invited individuals).ResultsThe mean age was 60.3±8.3 years in men and 59.8±8.5 years in women. The prevalence of MetS was 50.7% in women and 55.8% in men. The prevalence of MetS and its components, except high-density lipoprotein (HDL)-cholesterol, increased linearly with increasing serum calcium (P<0.001), even after adjustment for age, physical activity, alcohol, vitamin D intake, calcium intake, and smoking. The threshold value for serum calcium for MetS was 2.50 mmol/l in this population. The association of MetS with total serum calcium was similar even after exclusion of patients treated with hypertensive drugs. The drug treatments for hypertension, dyslipidemia, and diabetes increased in a similar pattern.ConclusionsSerum calcium level is associated with MetS and its components, except HDL-cholesterol.

Calcium-Alkali Syndrome Associated with Hypoparathyroidism Following Total Thyroidectomy

2020 ◽  
Vol 51 (2) ◽  
pp. 160-167
Author(s):  
Sayaka Kuroya ◽  
Masahiko Yazawa ◽  
Yugo Shibagaki ◽  
Naoto Tominaga
Keyword(s):  
Vitamin D ◽  
Renal Impairment ◽  
Total Thyroidectomy ◽  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Metabolic Alkalosis ◽  
Calcium Supplementation ◽  
Parathyroid Autotransplantation ◽  
High Calcium

Background: Patients with permanent postsurgical hypoparathyroidism, a complication of total thyroidectomy, often require high calcium supplementation with vitamin D to maintain serum calcium levels. The epidemiology of calcium-alkali syndrome (CAS) in patients with hypoparathyroidism after total thyroidectomy remains unclear. This study aimed to investigate the incidence of hypercalcemia, renal impairment, metabolic alkalosis, and CAS in patients treated for presumed hypoparathyroidism after total thyroidectomy. Methods: Twenty-seven patients with neck cancers who underwent total thyroidectomy without parathyroid autotransplantation between January 2010 and October 2013 at our hospital were consecutively included. All patients received calcium lactate and alfacalcidol for postsurgical hypocalcemia. We defined hypercalcemia as a corrected serum calcium level (cCa) ≥10.5 mg/dL, metabolic alkalosis as a difference in serum sodium and serum chloride ([sNa-sCl]) ≥39 mEq/L, and renal impairment as a ≥50% increase in serum creatine and/or ≥35% decrease in estimated glomerular filtration rate (eGFR) compared to baseline. Results: cCa peaked (11.1 ± 1.5 mg/dL) at a median of 326 days (interquartile range 78–869) after surgery. At peak cCa, [sNa-sCl] was significantly higher (p < 0.01), and eGFR was significantly lower (p < 0.01) than that at baseline. Fifteen patients (55.6%) had hypercalcemia, 19 (70.3%) had alkalosis, 12 (44.4%) had renal impairment, and 9 (33.3%) had CAS. Patients with CAS (mean age 67.1 ± 10.8 years) were older than those without CAS (56.7 ± 13.6 years, p = 0.06). The mean dose of alfacalcidol in the CAS group (3.1 ± 1.2 μg/day) was significantly larger than that in the non-CAS group (2.1 ± 1.0 μg/day, p = 0.03). Conclusions: This retrospective study reveals the high incidence of CAS in patients with hypoparathyroidism after total thyroidectomy. Furthermore, these findings suggest that the serum calcium level, acid-base balance, and renal function should be closely monitored in patients with postsurgical hypoparathyroidism who receive large doses of active vitamin D.

scholarly journals An Interesting Case of Isolated Bone Marrow Sarcoidosis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A180-A180
Author(s):  
Iqra Iqbal ◽  
Artem Minalyan ◽  
Muhammad Atique Alam Khan ◽  
Glenn A McGrath
Keyword(s):  
Bone Marrow ◽  
Vitamin D ◽  
Parathyroid Hormone ◽  
Parathyroid Adenoma ◽  
Bone Marrow Biopsy ◽  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Vitamin D Levels ◽  
High Calcium

Abstract Introduction: About 30% cases of sarcoidosis have extrapulmonary manifestations but only 7% of patients present without any lung involvement. Among those 7%, most of the patients have manifestations on the skin but isolated bone marrow sarcoidosis has not been commonly reported. This case represents an unusual manifestation of isolated bone marrow sarcoidosis presenting with very high calcium levels. Case Presentation: A 58-year-old female presented to us with fatigue, poor appetite, and nausea. She did not report any weight changes. Her cancer screening was up to date. On examination, she appeared dehydrated. No neck swelling was appreciated. Cardiac, respiratory, abdominal, and neurological examinations were normal. Complete blood count showed hemoglobin of 10.6 mg/dL, white blood cell count of 3.8 k/dL, and platelet count of 87 x109/L. Metabolic panel revealed hypercalcemia with corrected calcium levels as high as 12.6 mg/dL. Ionized calcium was 8.1 mg/dL (normal 4.8 - 5.6). Her parathyroid hormone (PTH) level was elevated up to 64.6 mg/dL and then further increased to 134.3 mg/dL. A 24-hour urinary calcium level was normal. 1, 25-dihydroxy (1,25-OH) and 25-OH vitamin D levels were 97 mg/dL (normal 18–72) and 31.2 mg/dL, respectively. Serum protein electrophoresis and light chain analysis were normal. Hyperparathyroidism was suggested as a cause of hypercalcemia. Ultrasound of the neck and sestamibi scan showed a right lower pole parathyroid adenoma. Paraneoplastic hypercalcemia was also one of the differentials. Parathyroid hormone related peptide (PTHrP) was 9 pg/mL (normal 14 - 27). Colonoscopy was normal. Computerized tomography showed normal lungs, liver and spleen. No masses and lymphadenopathy was seen. A bone marrow biopsy was done for pancytopenia. Patient underwent parathyroid adenoma removal followed by a drop in serum calcium level (8.2 mg/dL). Patient was discharged on calcium carbonate and vitamin D tablets. Upon outpatient follow-up, calcium level started to rise again up to 9.8 mg/dL. Despite discontinuation of supplemental calcium and vitamin D, calcium continued to uptrend (11.5 mg/dL 4 weeks later). Angiotensin converting enzyme (ACE) level came back as high as 129 (normal level &lt; 40 mcg/L). Meanwhile, the bone marrow biopsy results showed that 40% of bone marrow was occupied by non-caseating granulomas suggesting sarcoidosis. Patient was started on steroids for isolated bone marrow sarcoidosis, and eventually her serum calcium level normalized. Conclusion: An isolated bone marrow sarcoidosis is an extremely rare manifestation of extrapulmonary sarcoidosis. It can present with pancytopenia and should be sought in patients with persistent hypercalcemia. In addition, our case was challenging due to the presence of a concurrent hyperparathyroidism which was initially thought to be the only explanation of our patient’s hypercalcemia.

scholarly journals Association of Genetic Variants Related to Serum Calcium Levels with Reduced Bone Mineral Density

2019 ◽  
Vol 105 (3) ◽  
pp. e328-e336 ◽  
Author(s):  
Gloria Hoi-Yee Li ◽  
Cassianne Robinson-Cohen ◽  
Shivani Sahni ◽  
Philip Chun-Ming Au ◽  
Kathryn Choon-Beng Tan ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Bone Metabolism ◽  
Serum Calcium ◽  
Genetic Predisposition ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Whole Body ◽  
Mineral Density

Abstract Context The role of serum calcium in bone metabolism is unknown, even though calcium/vitamin D supplementations have been widely used and are expected to improve bone health. We aim to determine the independent role of serum calcium in bone mineral density (BMD). Design and setting Two epidemiological analyses with 5478 and 5556 participants from the National Health and Nutrition Examination Survey (NHANES) 2003 to 2006 and the Hong Kong Osteoporosis Study (HKOS) to evaluate the cross-sectional association of serum calcium with BMD. Two-sample Mendelian randomization (MR) studies using genetic variations as instrumental variables to infer causality. Summary statistics of genome-wide association study of serum calcium (N = 39 400) and lifelong whole-body BMD (N = 66 628) were used. Main outcome measure BMD measured by dual-energy X-ray absorptiometry Results In NHANES 2003–6 and HKOS, each standard deviation (SD) increase in serum calcium was significantly associated with 0.036–0.092 SD decrease in BMD at various sites (all P &lt; .05). In multivariable inverse-variance weighted MR analysis, genetic predisposition to higher serum calcium level was inversely associated with whole-body BMD after adjustment for serum parathyroid hormone, vitamin D, and phosphate (–0.431 SD per SD increase in serum calcium; 95% CI: –0.773 to –0.089, P = .014). Similar estimates were obtained in sensitivity analyses. Conclusions Our study reveals that genetic predisposition to higher serum calcium level per se may have a negative impact on bone metabolism. Whether increased serum calcium caused by calcium/vitamin D supplementations would have the same negative effect on bone remains unknown, which warrants further investigation. In addition to other adverse clinical outcomes, careful use of high-dose supplementations is required.

A case of severe, irreversible hypocalcemia after one dose of pamidronate administered for hypercalcemia of malignancy

2018 ◽  
Vol 25 (7) ◽  
pp. 1787-1793 ◽  
Author(s):  
Sophie Kim
Keyword(s):  
Vitamin D ◽  
Case Report ◽  
Vitamin D Deficiency ◽  
Cancer Patients ◽  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Elevated Serum ◽  
Baseline Serum ◽  
Hypercalcemia Of Malignancy

This is a case report of a patient who developed severe, irreversible hypocalcemia after receiving one dose of pamidronate 90 mg for hypercalcemia of malignancy. Hypocalcemia is a known risk of bisphosphonate treatments, but the incidence of severe hypocalcemia is rare, and the risk factors are well established. However, in the treatment of hypercalcemia of malignancy, the treatment objective is to reduce the elevated serum calcium level, and the bisphosphonate is usually given as one time dose only. The potential for developing severe hypocalcemia may not be considered a significant concern in this setting compared to the setting of the treatment of bone metastasis, where the baseline serum calcium level is not elevated and the bisphosphonate is administered at a regular interval of every three to four weeks. Furthermore, there is unawareness of prevalence of vitamin D deficiency in cancer patients, especially in those with advanced cancer, which may lead to inadvertent, severe hypocalcemia from bisphosphonate treatment. The objective of this case report is to bring awareness to the risk of severe hypocalcemia in patients with hypercalcemia of malignancy and the high prevalence of unrecognized vitamin D deficiency in cancer patients.

scholarly journals Correlation of pre-operative vitamin D3 levels with post-operative hypocalcemia in patients undergoing total thyroidectomy

2019 ◽  
Vol 7 (1) ◽  
pp. 128
Author(s):  
Mallikarjuna M. N. ◽  
Arun Kumar ◽  
Ramya M. V. ◽  
Santhosh C. S.
Keyword(s):  
Vitamin D ◽  
Total Thyroidectomy ◽  
Serum Calcium ◽  
Vitamin D3 ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Serum Vitamin ◽  
Hypovitaminosis D ◽  
Preoperative Serum ◽  
Vitamin D Levels

Background: Total thyroidectomy (TT) is a commonly performed procedure for various  thyroid disorders, with parathyroid insufficiency manifesting as hypocalcaemia being a well-known complication. Albeit, vitamin D is well implicated in calcium homeostasis, the association between hypovitaminosis D and postoperative hypocalcaemia is yet to be concluded. The aim of our study is to evaluate the correlation of preoperative serum vitamin D3 levels  with occurrence of post-operative hypocalcemia in patients undergoing TT.Methods: A prospective  study  was conducted on 50 patients  undergoing TT for benign thyroid diseases from November 2016 to May 2018. Pre-operative vitamin D3 levels were estimated. Serum calcium levels was measured pre‑ and post‑operatively at 24hours, 1st week and 4th week. Serum calcium level ≤8.5 mg/dl was considered as biochemical hypocalcemia. A data of demographic, clinical, biochemical and intraoperative findings were documented and analysed.Results: Statically 14 (28%) patients developed symptomatic hypocalcemia. Out of these, 11 (78.5%) patients had preoperative vitamin D levels of <30 ng/dl (p=0.034). 24 hours postoperative serum calcium level was significantly  lesser in patients with  lower preoperative vitamin D levels (p=0.015), suggesting that postoperative  hypocalcemia (24 hr) is statistically related to pre-operative vitamin D3 levels.Conclusions: It could be concluded from our study that preoperative serum vitamin D3 levels can predict post-operative occurrence of symptomatic and/or biochemical hypocalcemia. Thus, it could be hypothesized that supplementing vitamin D preoperatively could curb the incidence of hypocalcaemia following TT. However, further relevant trials are needed to attest to this. 

INFLUENCE OF DIET ON THE OCCURRENCE OF HYPERPHOSPHATEMIA AND HYPOCALCEMIA IN THE NEWBORN INFANT

PEDIATRICS ◽  
1951 ◽  
Vol 8 (6) ◽  
pp. 778-787
Author(s):  
ISAAC F. GITTLEMAN ◽  
JOSEPH B. PINCUS
Keyword(s):  
Vitamin D ◽  
Human Milk ◽  
Newborn Infant ◽  
Serum Calcium ◽  
Neonatal Period ◽  
Phosphorus Level ◽  
Calcium And Phosphorus ◽  
Normal Calcium ◽  
Phosphorus Levels

Studies on the effect of diets on the serum calcium and phosphorus levels in the newborn infant have been made. Human milk has been found to be the most effective in maintaining a normal calcium and phosphorus level. Evaporated milk has been found to be the least satisfactory because it tends to produce the largest number of instances of hyperphosphatemia and hypocalcemia. The desirability of adding vitamin D to the diets of infants in the neonatal period is questionable. In the infants studied, the hyperphosphatemia and hypocalcemia was more marked than in those who did not receive this supplement.

scholarly journals Severe Hypocalcemia and Resulting Seizure Caused by Vitamin D Deficiency in an Older Patient Receiving Phenytoin: Eldecalcitol and Maxacalcitol Ointment as Potential Therapeutic Options for Hypocalcemia

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Seishi Aihara ◽  
Shunsuke Yamada ◽  
Mika Kondo ◽  
Hideaki Oka ◽  
Taro Kamimura ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Therapeutic Option ◽  
Hydroxyvitamin D ◽  
Consciousness Disturbance ◽  
Symptomatic Epilepsy ◽  
25 Hydroxyvitamin D

An 82-year-old man treated with phenytoin for the prevention of symptomatic epilepsy was hospitalized to treat consciousness disturbance, seizure, and hypocalcemia (serum calcium: 4.6 mg/dL). Serum 25-hydroxyvitamin D level was very low (5.4 ng/mL), whereas serum calcitriol level was normal (27 pg/mL) and serum intact parathyroid hormone level was increased (369 pg/mL). He was finally diagnosed with vitamin D deficiency associated with low sunlight exposure and long-term phenytoin use for symptomatic epilepsy: phenytoin is shown to accelerate catabolism of 25-hydroxyvitamin D. Combination treatment with eldecalcitol and maxacalcitol ointments successfully normalized corrected serum calcium level: both eldecalcitol and maxacalcitol are vitamin D receptor activators used for osteoporosis and psoriasis, respectively. Our case illustrates the importance of periodic serum calcium level monitoring in patients receiving anti-epileptic drugs and the usefulness of eldecalcitol and maxacalcitol ointment as a therapeutic option for hypocalcemia, especially in countries where native vitamin D and 25-hydroxyvitamin D are not available.

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