Abstract
A small-for-date premature infant (gest.age =34 weeks, birthweight 1100g) had typical X-Rays aspect of rickets at birth. At the age of 4 days, low serum Ca= 8,2 mg/100 ml, low serum P = 5,4/100 ml and high serum alkaline phosphatase (A.P.) 323 IU/ml (≤ 200) were found. Very high level of serum iPTH was found at 17 days of age : 295 ulEq/ml (N<SO). Evidence of maternal vitamin D deficiency was shown by low plasma 25 OH CC : 1, I ng/ml (N 13 ± 4). Ca infusion (15 mg/kg/3h) resulted in marked decrease in iPTH (280 to 84 (μEq/ml). At the age of 30 days, administration of vitamin D2 (2400 u/day) for 10 days induced some healing of X-Ray aspect; A.P. remained high : 400 IU/ml; plasma 25 OH CC was normal 10, 2 ng/ml and serum iPTH decreased to 115 μlEq/ml. At the age of 40 days, oral administration of 25 OH CC (15 ug/24h) was given for on a week : it resulted in a rise of 25 OH CC to 64, 5 ng/ml with minor change of serum iPTH (94 μlEq/ml). This data show that :
1) a secondary hyperparathyroidism is present in congenital rickets
2) it is normally depressed by calcium-infusion
3) in view of the recent demonstration that 1-25 OHCC may be an important factor of regulation of PTH secretion (B. S. CHERTON et all. S.C.I. 56, 668, 1975), the absence of iPTH normalization in our case, in spite of nigh plasma 25 OH CC suggests a reduced activation of 25 OH CC.
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Sann, L., David, L., Frederich, A. et al. 5: Congenital rickets a premature infant: evolution of serum parathyroid hormone (iPTH) and plasma 25 hydroxycholecalciferol (25 OH CC). Pediatr Res 10, 874 (1976). https://doi.org/10.1203/00006450-197610000-00014
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DOI: https://doi.org/10.1203/00006450-197610000-00014
