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Biomedical subjects

J E Compston

Publications and source records attributed to J E Compston.

178 records · Page 10Linked to original sources
PubMed1979

Treatment of osteomalacia associated with primary biliary cirrhosis with parenteral vitamin D2 or oral 25-hydroxyvitamin D3.

The histological and biochemical response of osteomalacia has been studied in four patients with primary biliary cirrhosis, who were treated with oral 25-hydroxyvitamin D3, 50 microgram daily, or intramuscular vitamin D2, 150,000 units once weekly, for five to 12 months. All patients showed complete histological healing of osteomalacia, despite rapidly deteriorating liver function in three. Plasma 25-hydroxyvitamin D concentrations were low in all patients before treatment, but became normal during either vitamin therapy. Serum calcium and phosphate levels, and urinary calcium excretion were not always reliable in predicting the histological response to treatment. Serum alkaline phosphatase activity decreased in all patients during vitamin D therapy. We conclude that both high-dose parenteral vitamin D2 and oral 25-hydroxyvitamin D3 may be effective in healing osteomalacia associated with primary biliary cirrhosis. Measurement of plasma 25-hydroxyvitamin D levels during vitamin D therapy provides useful information about 25-hydroxylation of the parent vitamin and intestinal absorption of orally administered 25-hydroxyvitamin D3.

Administration, Oral↗
PubMed1978

Bone disease after jejuno-ileal bypass for obesity.

Bone tissue was examined in 21 patients who had undergone jejuno-ileal bypass for obesity between 1971 and 1974. 10 patients had osteomalacia with evidence of secondary hyperparathyroidism. Clinical symptoms and biochemical and radiological investigations were often unreliable in diagnosing bone disease, although plasma-25-hydroxyvitamin-D and plasma-phosphate concentrations were significantly lower and plasma-parathyroid-hormone concentrations were significantly higher in the patients with bone disease. The presence of osteomalacia was unrelated to age, length of time since bypass, or post-bypass weight-loss, and plasma-25-hydroxyvitamin-D levels did not correlate closely with bone histological changes. It is concluded that osteomalacia is common after jejuno-ileal bypass and that factors other than simple vitamin-D deficiency may contribute to its development.

Adult↗
PubMed1978

Osteomalacia after small-intestinal resection.

Histological examination of bone from 25 patients with small-intestinal resection showed that 9 (36%) had osteomalacia, which was severe in 5 and mild in 4. The serum-alkaline-phosphatase concentration was raised in all patients with severe osteomalacia, but serum calcium, phosphate, and alkaline-phosphatase concentrations were normal in the 4 patients with mild disease, 2 of whom had symptoms. Osteomalacia was diagnosed radiologically in only 3 patients. Osteomalacia appears to be commoner in patients with small-intestinal resection than has previously been thought, and bone biopsy is essential if all cases are detected. Although high-dose parenteral vitamin-D therapy is usually effective in the treatment of osteomalacia after small-intestinal resection, our findings showed that oral vitamin-D metabolites and their analogues may also be effective. This has important practical advantages.

Administration, Oral↗
PubMed1978

Oral 25-hydroxyvitain D3 in treatment of osteomalacia associated with ileal resection and cholestyramine therapy.

Severe histological osteomalacia developed in a woman with Crohn's disease 2 years after ileal resection and the start of cholestyramine therapy. Treatment with oral 25-hydroxyvitamin D3, 50 microgram daily, produced marked biochemical, radiological, and histological improvement after 6 months. It is suggested that cholestyramine, by reducing vitamin D absorption, precipitated the rapid development of osteomalacia in this patient. This case report emphasizes the importance of routine vitamin D supplementation in all patients on long term cholestyramine therapy, and indicates that even in patients with small intestinal disease or resection, oral preparations of vitamin D or its metabolities and analogues may be effective.

Administration, Oral↗
PubMed1977

Intestinal absorption of 25-hydroxyvitamin D and osteomalacia in primary biliary cirrhosis.

Bone histology and intestinal absorption of 25-hydroxyvitamin D3 (25-OHD) were investigated in 11 patients with primary biliary cirrhosis (P.B.C.). 4 patients had osteomalacia, and all these had received long-term cholestyramine. Plasma-25-hydroxyvitamin-D (25-OHD) concentrations after an oral dose of 25-OHD3 were significantly lower in the patients with P.B.C. (especially those with osteomalacia) than in normal controls. Serum calcium and urinary calcium excretion were lower, and serum-alkaline-phosphatase higher, in patients with osteomalacia. It is suggested that absorption of 25-OHD undergoing enterohepatic circulation and of dietary vitamin D is reduced in patients with P.B.C. Absorption of 25-OHD is further decreased by cholestyramine and the development of osteomalacia is thus hastened.

Aged↗
PubMed1977

Plasma levels and intestinal absorption of 25-hydroxyvitamin D in patients with small bowel resection.

Plasma levels of 25-hydroxyvitamin D (25-OHD) were found to be significantly reduced in a group of patients with small bowel resection when compared with normal controls. Plasma levels of 25-OHD after an oral dose of 25-hydroxyvitamin D3 (25-ohd3) were also reduced in the patient group. Dietary intake of vitamin D tended to be low in many patients, but seasonal variation of plasma 25-OHD levels indicated normal exposure to sunlight in most of the patients studied. It is suggested that these studies provide some evidence for malabsorption of 25-OHD after small bowel resection, which, it is postulated, may be due to interruption of the enterohepatic circulation of bile acids and of 25-OHD. These factors may contribute towards the low plasma levels of 25-OHD found in the patient group.

Adult↗
PubMedDate not supplied

Histomorphometric analysis of dynamic parameters of trabecular bone formation in the iliac crest of normal British subjects.

Some dynamic parameters of bone formation in trabecular iliac crest bone have been measured in a group of normal British subjects of both sexes over a wide age range. There was a significant age-related decrease in mean wall thickness. When either double plus single or double only tetracycline-labeled surfaces were used to represent actively mineralizing surfaces, there was a significant age-related decrease in the bone formation rate at the basic multicellular unit level. Osteoid maturation period showed a significant age-related increase when calculated using double plus single labeled surfaces. There was no significant change with age in fractional labeled surfaces, mean osteoid seam width, bone formation rate at tissue level, or bone formation period. The mean osteoid seam width and osteoid maturation period were significantly higher in males than in females.

Adult↗