Posttransplant bone disease: a case illustrating dramatic improvements in bone density with vitamin D replacement therapy.

Abstract:

:Although bisphosponates are proposed as first-line treatment for posttransplant bone disease they are not optimal in all situations. A kidney transplant recipient developed hypercalcemia from mobilization of extraskeletal calcium. He had low serum parathyroid hormone and vitamin D; high calcium excretion; and normal calcium intake. Bone biopsy revealed severe osteomalacia. Bisphosphonates, used in the early treatment of acute hypercalcemia, were not indicated to treat osteomalacia. However, over several months serum calcium declined sufficiently to allow treatment of the bone disease with oral calcitriol. Dual-energy radiographic absorptiometry over the next 2 years documented dramatic improvements in bone density (percent of young-normal controls) : from 63 to 85%, at the lumbar spine; from 38 to 67%, at the femoral neck. This response to treatment could not have been achieved with an antiresorptive strategy. Optimal management of posttransplant bone disease requires a diagnostic approach, which considers all plausible contributing factors.

journal_name

Transplantation

journal_title

Transplantation

authors

Dhingra RK,Sprague SM,Ojo AO,Leavey SF

doi

10.1097/00007890-200106270-00025

subject

Has Abstract

pub_date

2001-06-27 00:00:00

pages

1856-9

issue

12

eissn

0041-1337

issn

1534-6080

journal_volume

71

pub_type

杂志文章
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