ACUTE RESPONSE OF PARATHYROID HORMONE IN CONGENITAL OSTEOPETROSIS

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Abstract
Indices of Ca and P metabolism were studied in 3 children with osteopetrosis before and after infusion of bovine parathyroid hormone [PTH] extract. Basal plasma concentration of Ca, alkaline phosphatase and 25-hydroxy vitamin D tended to be low. Plasma immunoreactive PTH levels were at the upper normal range in 2 patients. A marked increase in urinary cyclic[c]AMP in all patients was solely due to an increase in the nephrogenous cAMP. After vitamin D treatment urinary cAMP was essentially unchanged with the same preponderance of nephrogenous cAMP. Following PTH infusion plasma cAMP showed a brisk rise. There was also a prompt rise in urinary cAMP and a distinct decrease in the Ca to Na clearance ratio indicating increased Ca reabsorption. A phosphaturic effect was only observed when PTH was given in the highest dose level. The findings apparently are consistent with a state of low grade hyperparathyroidism which could not be related to the plasma 25-hydroxy vitamin D or Ca levels.