What is Endocrinology - What is Paget's bone disease?
In the United States, Paget's disease affects roughly 1.5 million people. Because of an imbalance between osteoblastic bone synthesis and osteoclastic bone resorption, it is distinguished by aberrant bone architecture. According to skeletal evidence, Paget's illness originally struck populations in Western Europe around the Roman era. Osteitis deformans was the name Sir James Paget gave to the condition when he originally reported it in 1876. We now understand that Paget's illness of the bone is not an osteoid (osteitis) and rarely leads to deformity.
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What is Endocrinology - What side effects might a vitamin D2 or vitamin D metabolite treatment cause?
When using large dosages of vitamin D2 or one of the powerful vitamin D metabolites, it's crucial to keep a close eye out for the emergence of hypercalcemia. Asymptomatic mild hypercalcemia is possible. But individuals with severe hypercalcemia could experience anorexia, nausea, vomiting, weight loss, headache, constipation, polyuria, polydipsia, and a change in mental status. Nephrocalcinosis, nephrolithiasis, and even mortality could eventually result from impaired renal function. All calcium supplements and vitamin D preparations must be stopped right once, and hypercalcemia therapy must be started if vitamin D intoxication occurs. What is Endocrinology - How is vitamin D deficiency detected and why is it important?
It has only lately been recognised that low vitamin D levels are linked to low bone mass and an elevated risk of hip fracture. The ideal level of circulating 25-OHD is typically considered to be at least 30 ng/mL (75 nmol/L). A 25-OHD value of 10 or 20 ng/mL (25 or 50 nmol/L) is considered to be vitamin D deficient according to a number of authors and medical organisations. Between these inadequate and sufficient levels is the 25-OHD level in vitamin D deficiency. A frequent issue is having insufficient vitamin D levels. Only 23% of people in the National Health and Nutrition Examination Survey (2001–2004) population had circulation levels of 25-OHD above 30 ng/mL, while 6% had readings below 10 ng/mL, according to the data. Skeletal health begins to suffer as soon as circulating 25-OHD concentrations fall below critical levels. Therefore, it is sense to give vitamin D supplements to people who have circulating 25-OHD levels below 30 ng/mL. What is Endocrinology - What are the remedies for rickets and osteomalacia that are not caused by a lack of vitamin D?
Osteomalacia linked to VDDR type II requires the most potent vitamin D metabolite, 1,25-dihydroxyvitamin D, in extremely high dosages, as well as significant amounts of oral calcium in order to be effectively treated. In severe cases, intravenous calcium infusions at large doses are necessary to treat the rickets. Calcitriol is also used to treat VDDR type I, but physiologic levels are frequently adequate. Both phosphate supplements and calcitriol are required for the therapy of hypophosphatemic rickets in order to cure the bone disease. Osteomalacia brought on by tumours must be treated with either tumour excision or radiotherapy. The chelating drug deferoxamine can remove aluminium from damaged bone in chronic renal failure with aluminum-induced osteomalacia. Calcium and calcitriol can then be used to treat the bone condition. Vitamin D and bicarbonate are used to treat osteomalacia brought on by renal tubular acidosis and to balance the acidosis. What is Endocrinology - How is vitamin D deficiency detected and why is it important?
It has only lately been recognised that low vitamin D levels are linked to low bone mass and an elevated risk of hip fracture. The ideal level of circulating 25-OHD is typically considered to be at least 30 ng/mL (75 nmol/L). A 25-OHD value of 10 or 20 ng/mL (25 or 50 nmol/L) is considered to be vitamin D deficient according to a number of authors and medical organisations. Between these inadequate and sufficient levels is the 25-OHD level in vitamin D deficiency. A frequent issue is having insufficient vitamin D levels. Only 23% of people in the National Health and Nutrition Examination Survey (2001–2004) population had circulation levels of 25-OHD above 30 ng/mL, while 6% had readings below 10 ng/mL, according to the data. Skeletal health begins to suffer as soon as circulating 25-OHD concentrations fall below critical levels. Therefore, it is sense to give vitamin D supplements to people who have circulating 25-OHD levels below 30 ng/mL. What is Endocrinology - What are the remedies for rickets and osteomalacia that are not caused by a lack of vitamin D?
Osteomalacia linked to VDDR type II requires the most potent vitamin D metabolite, 1,25-dihydroxyvitamin D, in extremely high dosages, as well as significant amounts of oral calcium in order to be effectively treated. In severe cases, intravenous calcium infusions at large doses are necessary to treat the rickets. Calcitriol is also used to treat VDDR type I, but physiologic levels are frequently adequate. Both phosphate supplements and calcitriol are required for the therapy of hypophosphatemic rickets in order to cure the bone disease. Osteomalacia brought on by tumours must be treated with either tumour excision or radiotherapy. The chelating drug deferoxamine can remove aluminium from damaged bone in chronic renal failure with aluminum-induced osteomalacia. Calcium and calcitriol can then be used to treat the bone condition. Vitamin D and bicarbonate are used to treat osteomalacia brought on by renal tubular acidosis and to balance the acidosis. What is Endocrinology - Give an explanation of vitamin D insufficiency treatment.
Correcting hypocalcemia and the lack of active vitamin D metabolites through the administration of calcium salts and vitamin D preparations is the aim of treatment for patients with osteomalacia and rickets caused by an imbalance of vitamin D metabolism. There are several types of vitamin D accessible in the US, including vitamin D2 (ergocalciferol), vitamin D3 (cholecalciferol), 1,25-dihydroxyvitamin D (calcitriol), and calcitriol analogues. These formulations each have a unique half-life and potency. The underlying pathologic abnormality of vitamin D metabolism dictates the type and dosage of vitamin D preparation. Ergocalciferol combined with elemental calcium is frequently effective in treating osteomalacia in patients with vitamin D insufficiency. What is Endocrinology - What radiographic findings are related to rickets and osteomalacia?6/30/2022 What is Endocrinology - What radiographic findings are related to rickets and osteomalacia?
Before radiographic problems are seen, the metabolic abnormalities linked to rickets and osteomalacia are typically present. A decrease in bone mass is the most typical radiographic alteration seen in people with osteomalacia. Complete fractures as well as pseudofractures, sometimes known as Looser's zones or Milkman's fractures, may be seen. Pseudofractures are transverse radiolucent bands that are typically perpendicular to the bone's surface and range in length from a few millimetres to several centimetres. The femur, pelvis, and tiny bones in the hands and feet are where they are most frequently bilateral and prevalent. Secondary hyperparathyroidism may cause extra signs in patients with osteomalacia. These findings include brown tumours or bone cysts, lamina dura loss in the teeth, expansion of the gaps at the symphysis pubis and sacroiliac joints, and subperiosteal resorption of the phalanges. Children with rickets are more likely than other children to have certain radiographic abnormalities. These include bowing of the legs, expansion of the unmineralized epiphyseal growth plates, and fraying of the long bones' metaphyses. Even as adults, these skeletal malformations may still exist. What is Endocrinology - What disorders interfere with vitamin D metabolism or action have higher levels of the vitamin D metabolites?
Different vitamin D metabolite patterns may be seen depending on the abnormalities of vitamin D metabolism. 25-OHD levels are low in vitamin D deficiency nutritionally. Normal or elevated blood 25-OHD and low or undetectable serum 1,25-dihydroxyvitamin D levels are seen in VDDR type I, which is caused by a renal 25-hydroxyvitamin D-1a-hydroxylase enzyme shortage. In contrast, 25-OHD and 1,25-dihydroxyvitamin D levels are high in VDDR type II, which results in resistance of the target organs to 1,25-dihydroxyvitamin D. What is Endocrinology - What biochemical abnormalities are linked to vitamin D deficiency and osteomalacia and rickets?
Depending on the underlying flaw or process producing the bone illness, osteomalacia or rickets may present with different test findings. Understanding the body's reaction to hypocalcemia and being familiar with the vitamin D metabolic pathway are required to comprehend the biochemical anomalies seen in illnesses linked to aberrant vitamin D metabolism. Thus, low vitamin D levels lead to low or lownormal blood calcium concentrations in patients with nutritional vitamin D insufficiency or malabsorption, which induces increased PTH release (secondary hyperparathyroidism). Increased renal phosphate excretion, decreased serum phosphate, raised serum alkaline phosphatase levels, and decreased urine calcium excretion are all consequences of this hyperparathyroid condition. |
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