Impaired parathyroid hormone release in human immunodeficiency virus infection.
Patients with human immunodeficiency virus type 1 (HIV-1) seropositivity exhibited significantly lower intact serum parathyroid hormone (PTH) values (mean, 13.6 ng/liter; n = 44) than healthy controls (mean, 38.1 ng/liter; p < 0.001; n = 50). The reduction was greater among patients with no or mild immunodeficiency (> 400 x 10(6) CD4+ lymphocytes/ml blood; n = 22) than in those with severe immunodeficiency (< 200 x 10(6) CD4+ lymphocytes/ml blood; n 22; p = 0.03), although total serum calcium was normal in all groups. Patients with severe immunodeficiency demonstrated an inverse correlation between total serum calcium and serum PTH (r2 = 0.367; p < 0.01), which was also present in healthy controls (r2 = 0.482; p < 0.001), but not among the seropositive patients with no or mild immunodeficiency (r2 = 0.017; p = 0.58). Parathyroid cells express a protein recognized by antibodies directed against CD4, the HIV-1 receptor. This implies that these cells may be directly infected with HIV-1 and also interact with circulating autoantibodies against CD4, thus resulting in impaired PTH release.
Hellman
P
P
Department of Surgery, University Hospital, Uppsala, Sweden.
Albert
J
J
Gidlund
M
M
Klareskog
L
L
Rastad
J
J
Akerström
G
G
Juhlin
C
C
D001323:Autoantibodies / Q000097:blood; D015704:CD4 Antigens / Q000276:immunology; D015496:CD4-Positive T-Lymphocytes; D002118:Calcium / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000276:immunology; D015497:HIV-1; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D010280:Parathyroid Glands / Q000276:immunology; D010281:Parathyroid Hormone / Q000097:blood / Q000172:deficiency* / Q000378:metabolism
D001323:Autoantibodies; D015704:CD4 Antigens; D010281:Parathyroid Hormone; D002118:Calcium