Abstract
Cholestasis may lead to vitamin D deficiency and bone disease. We measured serum 25-OH vitamin D (25-OHD) (Haddad's assay, normal 20-40 ng/ml) and 1,25(OH)2D (Eisman's assay, normal 17-44 pg/ml) in 13 CC patients (x age 6 yrs, range 0.5-17) and 6 age comparable controls. CC patients had steatorrhea (coefficient of fat excretion 27 ± 6%, normal < 5%). 25-OHD absorption, maximal increase in 25-OHD (Δ25-OHD), was measured after 10 μg/kg oral 25-OHD.
10 of 13 CC patients had 25-OHD < 20 ng/ml, yet 7 of 10 had 1,25 (OH)2D levels (range 47-250 pg/ml) above adult values; 3 of 10 were above pediatric control values (120,165,250 pg/ml). There was no correlation between baseline 25-OHD, Δ25-OHD and 1,25(OH)2D levels (r = 0.18 and 0.06 respectively). No CC had active bone disease; serum calcium (9.8 ± 0.3 mg/dl) and phosphorus (5.5 ± 1.0 mg/dl) were normal in all. Parathyroid hormone was normal (< 180 μl-Eq/ml) in 10/11; in one infant it was 200 μl-Eq/ml. Conclusions: 1) Although serum 25-OHD and 25-OHD absorption are low in CC, serum 1,25(OH)2D may be normal or elevated. 2) We speculate that maintenance of 1,25(OH)2D levels is a response to calcium deficiency and compensatory mechanism to maintain calcium homeostasis.
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Farrell, M., Heubl, J., Tsang, R. et al. 1118 NORMAL OR ELEVATED SERUM 1,25 DIHYDROXYVITAMIN D3 (1,25(OH)2D)IN CHILDHOOD CHOLESTASIS (CC). Pediatr Res 15 (Suppl 4), 629 (1981). https://doi.org/10.1203/00006450-198104001-01144
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DOI: https://doi.org/10.1203/00006450-198104001-01144