By E. Blind, D. Flentje, S. Fischer (auth.), Professor Dr. med. Heinrich Schmidt-Gayk, Franz Paul Armbruster Dipl.Ing. (chem.), Professor Dr. Roger Bouillon (eds.)
Calcium metabolism is regulated through 3 particular hormones: parathor- mone, calciferol metabolites, and calcitonin. Cyclic AMP additionally performs a big half in calcium law, and its focus in urine will be taken as a degree of parathyroid functionality. tools for quantitative dimension of, e.g. calcium-regulating hormones and diet D metabolites in addition to of cAMP are completely valuable for secure differential analysis of ailments of the parathyroid like hypo- and hyperparathyroidism. during this monograph all almost immediately on hand equipment are summarized to whether they could already be acquired as try kits or are nonetheless being confirmed. Radioimmunoassays for some of the peptide fragments resembling 53-84, 44-68, 28-48, and 1-34 are defined, as are immunochemiluminescence equipment and adenylate cyclase bioassays. an identical is correct for the diet D metabolites, the place many of the assays for calcidiol and calcitriol corresponding to HPLC, protein-binding assay with moment antibody separation, and double antibody RIA are de§ scribed. eventually, choice of calcitonin and cAMP is mentioned intimately. it is a essentially and clinically orientated monograph for operating within the fields of inner drugs, endocrinology, and laboratory drugs.
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Additional info for Calcium Regulating Hormones, Vitamin D Metabolites, and Cyclic AMP Assays and Their Clinical Application
Acute or severe chronic insulin deficiency also depresses the formation of 1,25-(OH)2D. This has been well documented in diabetic rats but can also be found in diabetic man when the diabetes is severely out of control . In hypophosphatemic rickets low, normal, and even increased 1,25(OHhD levels have been observed. In classical, X-linked dominant hypophosphatemic rickets low or inappropriately low (versus circulating phosphate levels) 1,25-(OHhD levels are the rule and this may explain the associated low calcium absorption and excretion .
In active sarcoidosis, ectopic production of 1,25-(OH)2D probably occurs in monocyte-macrocyte noduli which are able to produce more 1,25-(OHhD than normally required, therefore firstly suppressing the normal renal secretion and finally resulting in excess 1,25-(OHhD, hypercalciuria, hypercalcemia, and functional hypoparathyroidism [4, 5, 29]. A similar pattern has occasionally been seen in other disorders of monocytesmacrophages (tuberculosis, foreign body granulomatosis, mycosis, and some types of lymphomas).
In most such cases 1,25-(OHhD is low or in the normal range, probably because the associated hypercalcemia results in mild renal failure. Only when renal function remains perfectly normal and/or is associated with parathyroid hyperfunction (primary hyperparathyroidism) will an overload of vitamin D and 25-0HD result in excess 1,25-(OH)2D levels. Vitamin D intoxication, at least due to vitamin D2 or D3 or its 25hydroxy analogs, therefore, can easily be detected by a screening 25-0HD assay (values well in excess of 100 ng/ml probably indicate imminent or real vitamin D intoxication), but vitamin D intoxication due to dihydrotachysterol excess or supraphysiological amounts of 11X-hydroxylated vitamin D metabolites cannot be detected by measuring 25-0HD levels.
Calcium Regulating Hormones, Vitamin D Metabolites, and Cyclic AMP Assays and Their Clinical Application by E. Blind, D. Flentje, S. Fischer (auth.), Professor Dr. med. Heinrich Schmidt-Gayk, Franz Paul Armbruster Dipl.Ing. (chem.), Professor Dr. Roger Bouillon (eds.)