Metabolic Aberrations of Renal Osteodystrophy
Treatment of rachitic and osteomalacic syndromes due to renal tubular acidosis should focus on the primary process rather than on the bone disease. Administration of alkali in the form of…
MUSCULOSKELETAL MEDICINE
Vitamin D–Resistant Rickets and Osteomalacia due to Renal Tubular Acidosis
Rickets or osteomalacia of variable degrees is a common manifestation of all the diverse conditions associated with renal tubular acidosis. Some of the rachitic disorders are life threatening, such as…
Vitamin D–Resistant Rickets and Osteomalacia due to Proximal and Distal Renal Tubular Defects
Three phosphate-wasting lesions in the proximal tubule have been identified. Type I, first described by Albright, is seen most frequently. It is transmitted as a sex-linked dominant trait and the…
Vitamin D–Dependent (Pseudodeficiency) Rickets and Osteomalacia
All of the findings and chemical abnormalities are similar to those seen in the classic nutritional deficiency syndrome, with the exception of the concentrations of the polar metabolites of vitamin…
Nutritional Deficiency: Rickets and Osteomalacia
ADULT OSTEOMALACIA Clinical Manifestations. The diagnosis of adult osteomalacia (see Plate 3-14) may be difficult to establish because the changes may be considerably more subtle than those seen in childhood…
Vitamin D–Resistant Rickets and Osteomalacia due to Proximal Renal Tubular Defects (Hypophosphatemic Rachitic Syndromes)
Vitamin D has receptors throughout many tissues and acts as both an endocrine as well as an autocrine/paracrine hormone. The endocrine properties have direct effects on bone and muscle tissue…
Adult Osteomalacia
CHILDHOOD RICKETS Clinical Manifestations. In severe childhood rickets (see Plate 3-13), growth is impaired and height is generally below the third quartile. However, unless there is concurrent severe nutritional disturbance,…
Clinical Guide to Parathyroid Hormone Assay (Continued)
In summary, the advent of totally automated immunometric I-PTH assays has led to improved accurate clinical discrimination of parathyroid disorders and has provided a tool to measure PTH levels in…
Clinical Guide to Parathyroid Hormone Assay: Different Forms of PTH and Their Detection by Whole (Bioactive) PTH and I-PTH Immunometric Assays
Measurement of biologically active intact PTH is essential for accurate clinical assessment. Today most laboratories use commercially available U.S. Food and Drug Administration (FDA)–approved two sites or sandwich immunometric assays…
Childhood Rickets
The causes of rachitic and osteomalacic syndromes are numerous and include a variety of genetic errors, nutritional abnormalities, metabolic disorders, and chronic renal diseases. Quite independent of cause, the clinical…
