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Related Experiment Videos

Calcium therapy for calcitriol-resistant rickets.

Z Hochberg1, D Tiosano, L Even

  • 1Department of Pediatrics, Rambam Medical Center, Haifa, Israel.

The Journal of Pediatrics
|November 1, 1992
PubMed
Summary

High-dose intravenous calcium effectively treats calcitriol-resistant rickets in children, improving bone pain and growth. Oral calcium is recommended early, with IV calcium used for active rickets to ensure healing.

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Area of Science:

  • Pediatric Endocrinology
  • Nutritional Medicine
  • Skeletal Biology

Background:

  • Calcitriol-resistant rickets, often due to vitamin D receptor defects, presents a significant treatment challenge.
  • Traditional therapies may be insufficient for severe cases, necessitating alternative approaches.

Purpose of the Study:

  • To evaluate the efficacy of high-dose elemental calcium therapy in children with calcitriol-resistant rickets.
  • To compare intravenous versus oral calcium administration routes and timing.

Main Methods:

  • Ten patients with vitamin D receptor defects received either high-dose intravenous or oral calcium therapy.
  • Treatment duration varied, with some patients transitioning from IV to oral calcium post-healing.
  • Growth velocity, biochemical markers, and radiologic evidence of rickets healing were monitored.

Main Results:

  • Intravenous calcium therapy led to rapid clinical improvement, including bone pain resolution and improved growth velocity.
  • Biochemical markers (serum calcium, PTH, phosphorus, alkaline phosphatase) normalized within a year.
  • Radiologic healing was faster with intravenous treatment, especially in younger patients.
  • Septicemia was a frequent complication of intravenous therapy.

Conclusions:

  • High-dose intravenous calcium is effective for treating active calcitriol-resistant rickets, promoting rapid healing and growth.
  • Early initiation of oral calcium therapy, to the limit of intestinal tolerance, is recommended.
  • Intravenous calcium infusion is crucial for achieving normocalcemia and healing when rickets is present, followed by oral therapy once healing is evident.

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