Linear growth in patients with hypophosphatemic vitamin D-resistant rickets: influence of treatment regimen and parental height.
The effects of different treatment regimens and the influence of parental height on the statural growth of 40 patients with hereditary vitamin D-resistant hypophosphatemic rickets were investigated. Three treatment regimens, each with oral phosphate, were used: vitamin D (0.5 to 2 mg/day), calcidiol (50 to 200 micrograms/day), and 1 alpha-hydroxyvitamin D3 (1 to 3 micrograms/day). Mean duration of follow-up was 9.5 +/- 5.1 years. The results show that (1) there was no acceleration of growth before puberty for the majority of children treated with vitamin D (12/16) or calcidiol (13/15), whereas 1 alpha-hydroxyvitamin D3 promoted catch-up growth in 10 of 16 patients; (2) height gain during puberty was normal, irrespective of the treatment; (3) most vitamin D-treated male and female subjects and calcidiol-treated male subjects had short adult stature, but the majority (75%) of the 1 alpha-hydroxyvitamin D3-treated groups had normal stature; (4) parental stature had little influence on the adult height of male subjects, but that of affected girls was positively correlated (p less than 0.002) with mid-parental height. These results demonstrate that 1 alpha-hydroxyvitamin D3 is superior to vitamin D or calcidiol for improvement of stature of patients with hypophosphatemic vitamin D-resistant rickets, and indicate the importance of parental height in determining the adult height of affected girls.
Balsan
S
S
Laboratoire des Tissue Calcifiés, University R. Descartes, Paris, France.
Tieder
M
M
D001827:Body Height; D002675:Child, Preschool; D002762:Cholecalciferol / Q000627:therapeutic use; D004872:Ergocalciferols / Q000627:therapeutic use; D005260:Female; D006128:Growth / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D006934:Hypercalcemia / Q000139:chemically induced; D007015:Hypophosphatemia, Familial / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D010290:Parents; D010710:Phosphates / Q000627:therapeutic use; D010758:Phosphorus / Q000097:blood; D011627:Puberty / Q000502:physiology; D012189:Retrospective Studies; D014807:Vitamin D / Q000009:adverse effects / Q000627:therapeutic use
D004872:Ergocalciferols; D010281:Parathyroid Hormone; D010710:Phosphates; D014807:Vitamin D; D002762:Cholecalciferol; D010758:Phosphorus