METABOLIC STUDIES IN PARALYTIC ACUTE ANTERIOR POLIOMYELITIS. II. ALTERATIONS IN CALCIUM AND PHOSPHORUS METABOLISM 1

Open Access
Publisher Website
Google Scholar
Abstract
The second report of a series on metabolic studies in poliomyelitis describes changes in Ca and P metabolism occurring over periods of 6 to 9 months in 9 extensively paralyzed patients. In 4 patients, observations were begun during the first week of the disease. Progressive increase in Ca excretion was noted, urinary Ca reaching high plateau levels by the 5th week after onset of illness. Maximal urinary Ca excretion averaged 0.572 g/day; mean maximal negative Ca balance averaged -0.540 g/day. Ca balance remained negative for an average of 7 months. Extent of Ca loss seemed related principally to the extreme degree of immobilization. X-ray demonstrable osteoporosis appeared 3 months after onset near joints of the long bones in the lower extremities, accompanied by an average total Ca loss of 2% of the estimated total body Ca. Observations of the urinary volume, pH, and citric acid excretion indicated a suitable setting for urinary tract calculus formation in male patients. Serum Ca tended to rise in 4 of 7 patients studied during acute and convalescent phases. Excessive early loss of P was noted followed by relative retention during the 3d. and 8th week; the time parallel between these alterations and the pathological changes in P-rich nerve tissue was noted. Ambulation did not exert a definite moderating influence on mineral loss.