Idiopathic Hypoparathyreoi-dism with Celiac Disease – Diagnostic and Therapeutic Problem
Idiopatická hypoparatyreóza s celiakií -diagnostické a léčebné problémy
U ženy středního věku se postupně manifestovaly choroby, jejichž společným jmenovatelem jes největší pravděpodobností autoimunitní proces. Autoři popisují 7 roků trvající vývoj klinickéhostavu, při němž se zkombinovala hypoparatyreóza s celiakií nereagující na dietní opatření. Ma-labsorpce se manifestovala selektivním blokem pro resorpci vápníku ze střeva. Zajímavá je poru-cha konverze vitaminu D2 na D3, která má zřejmě multifaktoriální etiologii. Jako hlavní problémse jeví sklon reagovat tachyfylaxí na perorální podávání vitaminu D. Jediným účinným léčebnýmpostupem se mimo výše vyjmenovaná terapeutická opatření zatím jeví parenterální aplikacevitaminu D3, kalcitriolu.
Klíčová slova:
Idiopatická hypoparatyreóza - Celiakie - Malabsorpce - Granulomatózní hepatitis
Authors:
K. Lukáš; M. Lukáš
Authors‘ workplace:
I. interní klinika FN, Olomouc, přednosta prof. MUDr. J. Lukl, CSc. 1 Interní ambulance Valašské Meziříčí 2 Oddělení imunologie FN, Olomouc, přednosta doc. MUDr. E. Weigl, CSc.
Published in:
Prakt. Lék. 2000; (1): 408-412
Category:
Overview
A middle-aged woman developed gradually diseases where most probably the common denomina-tor is an autoimmune process. The authors describe the clinical condition persisting for sevenyears, where hypoparathyroidism was associated with coeliac disease which did not respond todietary measures. Malabsorption was manifested by a selective block for calcium absorption fromthe gut. The impaired conversion of vitamin D2 to D3 is of interest; it has obviously a multifactori-al etiology. The main problem is the patient´s tendency to respond by tachyphylaxis to oralvitamin D administration. The only effective therapeutic procedure apart from those listed is sofar parenteral administration of vitamin D3, calcitrol.
Key words:
Idiopathic hypoparathyroidism - Celiac disease - Malabsorption - Granulomatous
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2000 Issue 1
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