Skip to main content
SpringerLink
Log in

Hypocalcaemia induced by glucocorticoids in a child with hypoparathyroidism treated with 1-α-hydroxyvitamin D3

  • Short Communications
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Glucocorticoids tend to lower the intestinal absorption of calcium, leading to a negative calcium balance. A 7-year-old girl with hypoparathyroidism was maintained as normocalcaemic on 1-α-hydroxyvitamin D3 (1αD3) and calcium gluconate lactate. During an episode of aplastic anaemia she was treated with prednisolone, with a subsequent dramatic fall of serum calcium despite 1αD3 treatment and serum 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) in the high-normal range. Glucocorticoids seem to have interfered directly with cellular events reponsible for intestinal absorption of calcium.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abbreviations

1αD3 :

1-α-hydroxyvitamin D3

1,25(OH)2D3 :

1,25-dihydroxyvitamin D3

PTH:

parathyroid hormone

PTE:

parathyroid extract

RIA:

radioimmunoassay

TRP:

tubular reabsorption of phosphorus

References

  1. Aloia JF, Roginsky M, Ellis K, Shukla K, Cohn S (1974) Skeletal metabolism and body composition in Cushing's syndrome. J Clin Endocrinol Metab 39:981–985

    Google Scholar 

  2. Au WYW (1976) Cortisol stimulation of parathyroid hormone secretion by rat parathyroid glands in organ culture. Science 193:1015–1017

    Google Scholar 

  3. Avioli LV, Birge SJ, Lee SW (1968) Effects of prednisone on vitamin D metabolism in man. J Clin Endocrinol Metab 29:1347–1352

    Google Scholar 

  4. Chesney RW, Mazess RB, Hamstra AJ, DeLuca HF (1978) Reduction of serum 1,25-dihydroxyvitamin D3 in children receiving glucocorticoids. Lancet 2:1123–1125

    Google Scholar 

  5. Fucik RF, Kukreja SC, Hargis CK, Bowser EN, Henderson WJ, Williams GA (1975) Effect of glucocorticoids on function of the parathyroid glands in man. J Clin Endocrinol Metab 40:152–155

    Google Scholar 

  6. Hahn TJ, Halstead LR (1979) Cortisol enhancement of PTH-stimulated cyclic AMP accumulation in cultured fetal rat long bone rudiments. Calcif Tissue Int 27: 173–176

    Google Scholar 

  7. Hahn TJ, Halstead LR, Haddad JG Jr (1977) Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 90:399–404

    Google Scholar 

  8. Hahn TJ, Halstead LR, Teitelbaum SL, Hahn BH (1979) Altered mineral metabolism in glucocorticoid-induced osteopenia: effect of 25-hydroxyvitamin D administration. J Clin Invest 64:655–665

    Google Scholar 

  9. Hahn TJ, Halstead LR, Baran DT (1981) Effect of short-term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentration in man. J Clin Endocrinol Metab 52:111–115

    Google Scholar 

  10. Klein RG, Arnaud SB, Gallagher JC, DeLuca HF, Riggs BL (1977) Intestinal calcium absorption in exogenous hypercortisolism: role of 25-hydroxyvitamin D and corticosteroid dose. J Clin Invest 60: 253–259

    Google Scholar 

  11. Lukert BP, Adams JS (1976) Calcium and phosphorus homeostasis in man: effect of corticosteroids. Arch Intern Med 136: 1249–1253

    Google Scholar 

  12. Wajchenberg BL, Pereira VG, Kieffer J, Ursic S (1969) Effect of dexamethasone on calcium metabolism and Ca kinetics in normal subjects. Acta Endocrinol 61:173–192

    Google Scholar 

  13. Weisman Y, Schen RJ, Eisenberg Z, Edelstein S, Harell A (1981) Inadequate status and impaired metabolism of vitamin D in the elderly. Isr J Med Sci 17:19–21

    Google Scholar 

  14. Williams GA, Peterson WC, Bowser EN, Henderson WJ, Hargis GK, Martinez NJ (1974) Interrelationship of parathyroid and adrenocortical function in calcium homeostasis in the rat. Endocrinology 95: 707–712

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics A, Rambam Medical Center, P.O.B. 9602, 31096, Haifa, Israel

    P. Vardi, A. Benderly, A. Etzioni, J. Levy & Z. Hochberg

  2. Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel

    P. Vardi, A. Benderly, A. Etzioni, J. Levy & Z. Hochberg

Authors
  1. P. Vardi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Benderly
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Etzioni
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Levy
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Z. Hochberg
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vardi, P., Benderly, A., Etzioni, A. et al. Hypocalcaemia induced by glucocorticoids in a child with hypoparathyroidism treated with 1-α-hydroxyvitamin D3 . Eur J Pediatr 144, 280–282 (1985). https://doi.org/10.1007/BF00451962

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00451962

Key words

Search

Navigation