The relief of bone pain in primary biliary cirrhosis with calcium infusions

Ajdukiewicz, A.B.; Agnew, J. E.; Byers, Paul D.; Wills, M. R.; Sherlock, Sheila

doi:10.1136/gut.15.10.788

Cited by 32 publications

(6 citation statements)

References 9 publications

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“…In healthy postmenopausal women, weight-bearing exercise and oral calcium supplements are of some benefit, 35 but, in primary biliary cirrhosis, the effect of calcium supplementation on bone mineral density is modest. 36,37 In the present study, treatment with calcium and vitamin D for 1 year did not prevent a significant 0.87% decrease in L2-L4 bone mineral density, and urinary markers of bone turnover remained unchanged. In contrast, transdermal HRT resulted in a significant 2.25% increase in the lumbar spine bone mineral density, and an associated decrease in the urinary excretion of deoxypyridinoline and calcium.…”

Section: Discussioncontrasting

confidence: 61%

“…There are few treatment modalities which have been shown in adequately designed trials to reduce or reverse bone loss in primary biliary cirrhosis. In healthy post‐menopausal women, weight‐bearing exercise and oral calcium supplements are of some benefit, 35 but, in primary biliary cirrhosis, the effect of calcium supplementation on bone mineral density is modest 36 ,. 37 In the present study, treatment with calcium and vitamin D for 1 year did not prevent a significant 0.87% decrease in L2–L4 bone mineral density, and urinary markers of bone turnover remained unchanged.…”

Section: Discussionmentioning

confidence: 99%

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Transdermal hormone replacement therapy improves vertebral bone density in primary biliary cirrhosis: results of a 1‐year controlled trial

Pereira

O’Donohue

Moniz³

et al. 2004

Aliment Pharmacol Ther

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SUMMARYBackground: Retrospective studies have suggested that hormone replacement therapy may reduce the rate of bone loss in primary biliary cirrhosis, but no controlled data are available. Methods: Forty-two post-menopausal women with primary biliary cirrhosis were treated with calcium and vitamin D, either alone (n ¼ 21) or together with transdermal hormone replacement therapy (n ¼ 21). Bone densitometry was performed at baseline and at 1 year, and serum and urinary markers of bone turnover were measured at three-monthly intervals. Results: At entry, 17 patients (40%) had spinal or femoral osteopenia (T score ) 1 to ) 2.5) and nine (21%) had osteoporosis (T < ) 2.5). In those given hormone replacement therapy, there was a significant decrease in the mean urinary deoxypyridinoline :

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Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Transdermal hormone replacement therapy improves vertebral bone density in primary biliary cirrhosis: results of a 1‐year controlled trial

Pereira

O’Donohue

Moniz³

et al. 2004

Aliment Pharmacol Ther

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“…The requirements of large parenteral doses of vitamin D to improve calcium malabsorption (Kehayoglou et al, 1968;Whelton et al, 1971), and the persistence of this malabsorption in spite of these measures (Ajdukiewicz et al, 1974), have been attributed to a state of relative vitamin D resistance. There appears to be no defect of hepatic 25 hydroxylation in these patients (Krawitt et al, 1977), and there is no real evidence to suggest impaired renal lot hydroxylation.…”

Section: Discussionmentioning

confidence: 99%

Effect of oral 1,25 dihydroxycholecalciferol on calcium and phosphate malabsorption in primary biliary cirrhosis.

Farrington¹,

Epstein²,

Varghese³

et al. 1979

Gut

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SUMMARY Changes in calcium and phosphate absorption in response to treatment with small doses of oral 1,25 (OH)2D3 were studied in 10 patients with primary biliary cirrhosis by means of a combined radio-isotope technique. There was a marked improvement in the fractional rates of absorption of calcium (P < 0 01) and phosphate (0 05 < P < 0 1) after treatment. This implies that there is no end organ unresponsiveness to the action of active Vitamin D metabolites at the intestinal level in primary biliary cirrhosis.Calcium and phosphate malabsorption is a recognised feature of primary biliary cirrhosis (PBC) (Whelton et al., 1971;Long et al., 1978b)

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“…This would be sup ported by the known metabolic events leading to negative balance of calcium in cirrhosis (poor nutrition, intestinal malabsorption and impaired vitamin D metabolism [16][17][18]). However, the fact that liver damage was pres ent in all patients, and since plasma calcium concentration was comparable in both ex perimental groups, it can be assumed that the level of parathyroid function was similar in the control as well as in the patients with ascites.…”

Section: Discussionmentioning

confidence: 99%

Tubular Handling of Sodium and Phosphate in Cirrhosis with Salt Retention

Rochman¹,

Chaimovitz²,

Szylman³

et al. 1978

Nephron

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Tubular handling of sodium and phosphate were studied in 4 patients with cirrhosis and ascites. The control group consisted of 5 patients with cirrhosis without sodium retention. The degree of phosphaturia was assumed to reflect proximal tubular reabsorption. Whereas fractional excretion of phosphate was comparable in both groups, fractional excretion of sodium was strikingly diminished in the patients with ascites. This observation suggests that sodium retention in these patients occurs beyond the proximal tubule. This interpretation is in accord with our previous observation, based on clearance data, that the proximal tubular reabsorption of sodium in cirrhosis may be normal even in the face of edema formation.

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The relief of bone pain in primary biliary cirrhosis with calcium infusions

Cited by 32 publications

References 9 publications

Transdermal hormone replacement therapy improves vertebral bone density in primary biliary cirrhosis: results of a 1‐year controlled trial

Transdermal hormone replacement therapy improves vertebral bone density in primary biliary cirrhosis: results of a 1‐year controlled trial

Effect of oral 1,25 dihydroxycholecalciferol on calcium and phosphate malabsorption in primary biliary cirrhosis.

Tubular Handling of Sodium and Phosphate in Cirrhosis with Salt Retention

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