Abstract
In 1972 Jowsey showed in dogs that bone became unresponsive to PTH in the presence of much osteoid (J. Clin. Invest. 51: 9, 1972). This might also explain the elevated PTH-levels in vitamin D-deficient rickets in man. But if rachitic bone structure is the cause of the raised plasma-PTH values, this should be independent of vitamin D and therefore plasma-PTH levels in other types of rickets should also be above normal. This was examined in 2 patients with hypophosphataemic rickets (a 16-year-old boy and a 7-year-old girl). Serum-Ca and plasma-PTH were determined simultaneously. A bone biopsy, taken at the same time, was embedded in methyl-methacrylate without decalcification, and 100 μ, thick sections were made. These were examined microscopically: the length of the bone surface, covered with osteoid, was measured and expressed as a fraction of the total length of the surface. Serum-Ca and plasma-PTH were normal, whilst more than 75 % of the bone surface was covered with osteoid. These findings do not support the hypothesis that in man the effect of PTH on the homeostasis of calcium is inhibited by severe rachitic changes of bone tissue.
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Steendijk, R. Plasma-PTH, serum-Ca and bone structure in hypophosphataemic (vitamin D-resistant) rickets.. Pediatr Res 8, 897 (1974). https://doi.org/10.1203/00006450-197411000-00023
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DOI: https://doi.org/10.1203/00006450-197411000-00023