PEDIATRICS Vol. 64 No. 4 October 1979, pp. 488-495
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Hypophosphatemic Rickets: Effect of 1agr, 25-Dihydroxyvitamin D3 on Growth and Mineral Metabolism

James C. M. Chan MD1 and Frederic C. Bartter MD1

1 Hypertension-Endocrine Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland

Growth retardation nearly invariably accompanies hypophosphatemic rickets. Studies were conducted in an adolescent male with this disorder as follows. Protocol I: age, 6 to 16 years; treatment per day, 5,000 to 80,000 units vitamin D2, 1,760 to 2,200 mg phosphorus, orally as buffered phosphate; growth velocity, 5 to 6 cm/year. Protocol II: age 16 to 17 years; treatment per day, 1agr,25-dihydroxyvitaniin D3, 1 µg; 2,200 mg of phosphorus, orally as buffered phosphate; growth velocity, 14 cm/year. The height improved from less than third percentile for the decade during study protocol I to the 25th percentile during protocol II. Mineral balance studies showed a reduction of urinary and stool phosphorus during treatment protocol II, while the patient was receiving metabolic diet. The serum phosphorus improved from 2.2 to 4.3 mg/dl and radiologic healing of rickets was documented. No hypercalcemic episode was encountered. The data support the contention that lagr,25-dihydroxyvitamin D3 is the treatment of choice for hypophosphatemic rickets.

Submitted on December 8, 1978
Accepted on January 29, 1979




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