Parathyroid function and serun calcitonin in children receiving phenytoin drugs.
In various bone diseases (b.d.) associated with secondary hyperparathyroidism, serum calcitonin (ct) levels are high, which seems to inhibit demineralisation. In pigs, phenytoin inhibits ct secretion. To further elucidate the pathogenesis of anticonvulsant b.d., serum ct levels and several parameters of parathyroid function were studied in 29 anticonvulsive treated children and 35 controls. In patients, mean values of serum calcium and phosphate, urinary calcium/creatinine (Uca/cr), and phosphate reabsorption (TmPO4/GFR) were significantly decreased, serum alkaline phosphatase (AP), parathyroid hormone (iPTH) and urinary cyclic AMP (UcAMP) were significantly increased. AP and iPTH were correlated to UcAMP (p<.001), whereas iPTH and UcAMP were inversely correlated to Uca/cr (p<.001 and p<.05). Serum ct levels were significantly decreased (median 100 pg/ml, range<100-520 pg/ml; controls: median 150 pg/ml, range <100-740 pg/ml, p<.05). ct levels were low (≤200 pg/ml) even in 6 patients with obvious hyperparathyroidism (iPTH 6.2-12.1 pmol/l, controls: < 5.3 pmol/l). Thus, drug induced reduction of ct mediated inhibition of skeletal resorption is probably an additional pathogenetic factor in anticonvulsant bone disease.
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Kruse, K., Bartels, H. & Ziegler, R. Parathyroid function and serum calcitonln in children receiving phenytoin drugs: 47. Pediatr Res 14, 173 (1980). https://doi.org/10.1203/00006450-198002000-00074