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Evidence for abnormal regulation of circulating 1α,25-dihydroxyvitamin D in patients with pulmonary tuberculosis and normal calcium metabolism

  • Clinical Investigations
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Summary

Available evidence indicates that hypercalcemia in pulmonary tuberculosis results from increases in circulating 1α,25-dihydroxyvitamin D [1α,25(OH)2D]. To further characterize vitamin D metabolism in this disorder, the effects of vitamin D, 100,000 units a day for 4 days, were compared in 25 normal subjects and 11 patients with active pulmonary tuberculosis who were normocalcemic and had not had hypercalcemia. Serum calcium, phosphorus, 25-hydroxyvitamin D (25-OHD) and 1α,25(OH)2D were measured. Whereas vitamin D increased mean serum 25-OHD from 20±2 (±SE) to 40±5 ng/ml (P<0.001) and did not change mean serum 1α,25(OH)2D in the normals (33±2 vs. 31±2 pg/ml), it increased mean serum 25-OHD from 21±4 to 55±13 ng/ml (P<0.05) and mean serum 1α,25(OH)2D from 28±2 to 35±3 pg/ml (P<0.05) in the patients. Serum calcium was normal and remained within the normal range in all subjects and patients. The findings indicate that there is a modest but significant abnormality in the regulation of circulating 1α,25(OH)2D in normocalcemic patients with pulmonary tuberculosis. The results are similar to those previously reported by us in normocalcemic patients with sarcoidosis.

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Author notes

  1. Sol Epstein

    Present address: Department of Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania

Authors and Affiliations

  1. Department of Medicine, Indiana University Medical School, Indianapolis, Indiana

    Sol Epstein & Ian Dowdeswell

  2. Department of Pharmacology, Northwestern University Medical School, Chicago, Illinois

    Paula H. Stern

  3. Veterans Administration Medical Center and Departments of Medicine and Pharmacology, Medical University of South Carolina, 29403, Charleston, South Carolina, USA

    Norman H. Bell & Russell T. Turner

Authors
  1. Sol Epstein
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  2. Paula H. Stern
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  3. Norman H. Bell
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  4. Ian Dowdeswell
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  5. Russell T. Turner
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Epstein, S., Stern, P.H., Bell, N.H. et al. Evidence for abnormal regulation of circulating 1α,25-dihydroxyvitamin D in patients with pulmonary tuberculosis and normal calcium metabolism. Calcif Tissue Int 36, 541–544 (1984). https://doi.org/10.1007/BF02405362

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  • DOI: https://doi.org/10.1007/BF02405362

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