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Abnormal calcium metabolism caused by increased circulating 1,25-dihydroxyvitamin D in a patient with rheumatoid arthritis.
J Bone Miner Res 1986; 1(2):221-6JB

Abstract

A 35-year-old white male with rheumatoid arthritis who had developed hypercalcemia, hypercalciuria, and nephrolithiasis was found to be abnormally sensitive to vitamin D as a result of lack of regulation of circulating 1,25-dihydroxyvitamin D (1,25-(OH)2D). An increase in daily intake of vitamin D from 10 micrograms (400 units) per day to 50 micrograms (2000 units) per day produced an abnormal elevation in serum 1,25-(OH)2D, hypercalcemia, and hypercalciuria which were corrected by prednisone. Serum 25-hydroxyvitamin D initially was abnormally low, and increased with vitamin D to values which were in the low normal range. There were significant positive correlations between serum 1,25-(OH)2D (p less than .05) and serum calcium and between serum 1,25-(OH)2D and urinary calcium (p less than .05). Serum immunoreactive parathyroid hormone, initially in the lower range of normal, decreased further during hypercalcemia. A radiograph of the chest, gallium scan, and serum angiotensin-converting enzyme activity were normal. No granulomas or evidence of lymphoma were found in biopsies of the liver and of several lymph nodes. It is concluded that the abnormal calcium metabolism in this patient resulted from increased circulating 1,25-(OH)2D and that the defect in vitamin D metabolism was not related to sarcoidosis, other granulomatous disease, Hodgkin's disease, or lymphoma. The relationship, if any, of the abnormal metabolism of vitamin D and calcium to rheumatoid arthritis remains to be established.

Authors+Show Affiliations

Veterans Administration Medical Center, Albany, NY.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

3503540

Citation

Gates, S, et al. "Abnormal Calcium Metabolism Caused By Increased Circulating 1,25-dihydroxyvitamin D in a Patient With Rheumatoid Arthritis." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 1, no. 2, 1986, pp. 221-6.
Gates S, Shary J, Turner RT, et al. Abnormal calcium metabolism caused by increased circulating 1,25-dihydroxyvitamin D in a patient with rheumatoid arthritis. J Bone Miner Res. 1986;1(2):221-6.
Gates, S., Shary, J., Turner, R. T., Wallach, S., & Bell, N. H. (1986). Abnormal calcium metabolism caused by increased circulating 1,25-dihydroxyvitamin D in a patient with rheumatoid arthritis. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 1(2), pp. 221-6.
Gates S, et al. Abnormal Calcium Metabolism Caused By Increased Circulating 1,25-dihydroxyvitamin D in a Patient With Rheumatoid Arthritis. J Bone Miner Res. 1986;1(2):221-6. PubMed PMID: 3503540.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Abnormal calcium metabolism caused by increased circulating 1,25-dihydroxyvitamin D in a patient with rheumatoid arthritis. AU - Gates,S, AU - Shary,J, AU - Turner,R T, AU - Wallach,S, AU - Bell,N H, PY - 1986/4/1/pubmed PY - 1986/4/1/medline PY - 1986/4/1/entrez SP - 221 EP - 6 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J. Bone Miner. Res. VL - 1 IS - 2 N2 - A 35-year-old white male with rheumatoid arthritis who had developed hypercalcemia, hypercalciuria, and nephrolithiasis was found to be abnormally sensitive to vitamin D as a result of lack of regulation of circulating 1,25-dihydroxyvitamin D (1,25-(OH)2D). An increase in daily intake of vitamin D from 10 micrograms (400 units) per day to 50 micrograms (2000 units) per day produced an abnormal elevation in serum 1,25-(OH)2D, hypercalcemia, and hypercalciuria which were corrected by prednisone. Serum 25-hydroxyvitamin D initially was abnormally low, and increased with vitamin D to values which were in the low normal range. There were significant positive correlations between serum 1,25-(OH)2D (p less than .05) and serum calcium and between serum 1,25-(OH)2D and urinary calcium (p less than .05). Serum immunoreactive parathyroid hormone, initially in the lower range of normal, decreased further during hypercalcemia. A radiograph of the chest, gallium scan, and serum angiotensin-converting enzyme activity were normal. No granulomas or evidence of lymphoma were found in biopsies of the liver and of several lymph nodes. It is concluded that the abnormal calcium metabolism in this patient resulted from increased circulating 1,25-(OH)2D and that the defect in vitamin D metabolism was not related to sarcoidosis, other granulomatous disease, Hodgkin's disease, or lymphoma. The relationship, if any, of the abnormal metabolism of vitamin D and calcium to rheumatoid arthritis remains to be established. SN - 0884-0431 UR - https://www.unboundmedicine.com/medline/citation/3503540/Abnormal_calcium_metabolism_caused_by_increased_circulating_125_dihydroxyvitamin_D_in_a_patient_with_rheumatoid_arthritis_ L2 - https://doi.org/10.1002/jbmr.5650010209 DB - PRIME DP - Unbound Medicine ER -