Calcium and Phosphate Hormones: Vitamin D, Parathyroid Hormone, and Fibroblast Growth Factor 23
| Autor: | Lisa Underland, Morri E. Markowitz, Robert C. Gensure |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Vitamin
Fibroblast growth factor 23 medicine.medical_specialty Calcitriol Hypoparathyroidism Hypophosphatemia Parathyroid hormone Rickets Diagnosis Differential 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Reference Values 030225 pediatrics Internal medicine medicine Vitamin D and neurology Humans 030212 general & internal medicine Vitamin D business.industry Phosphorus medicine.disease Vitamin D Deficiency Fibroblast Growth Factors Fibroblast Growth Factor-23 Endocrinology chemistry Parathyroid Hormone Pediatrics Perinatology and Child Health Calcium business Cholecalciferol medicine.drug Hormone |
| Zdroj: | Pediatrics in review. 41(1) |
| ISSN: | 1526-3347 |
| Popis: | 1. Lisa Underland, DO* 2. Morri Markowitz, MD* 3. Robert Gensure, MD, PhD† 1. *Children’s Hospital at Montefiore, the University Hospital for Albert Einstein College of Medicine, Bronx, NY 2. †Tufts Medical Center, Tufts University School of Medicine, Boston, MA * 1,25-D: : 1,25-dihydroxyvitamin D 25-D: : 25-hydroxyvitamin D CaSR: : calcium-sensing receptor DMP1: : dentin matrix acidic phosphoprotein 1 FDA: : Food and Drug Administration FGF23: : fibroblast growth factor PTH: : parathyroid hormone PTHrP: : parathyroid hormone–related peptide Disorders of vitamin D, parathyroid hormone, and fibroblast growth factor 23 encompass both very rare and fairly common patient presentations in the pediatric population, and so understanding the differential diagnosis is important. After completing this article, readers should be able to: 1. Understand the basic interplay among vitamin D, parathyroid hormone, and fibroblast growth factor 23 in the maintenance of optimal calcium and phosphorous levels and bone health. 2. Understand the differential diagnosis and basic evaluation of hormonal disorders resulting in low calcium and/or phosphorous levels. 3. Understand the basics of presentation, pathophysiology, and treatment of these hormone disorders. Plasma calcium and phosphorous concentrations are regulated by 3 major players: hormonal vitamin D, parathyroid hormone (PTH), and fibroblast growth factor 23 (FGF23). Understanding the interplay among them is essential for assessing calcium and phosphorous levels in children. This is especially important for pediatricians as they care for patients during the crucial times in bone formation and accrual as well as growth. This review focuses on the normal physiology as well as evaluation and treatment of the diseases associated with dysfunctions that result in too little calcium or phosphate in blood. ### Physiology: Vitamin D Production and Action Vitamin D is a precursor molecule to a critical hormone, calcitriol, involved in calcium and, to a lesser extent, phosphorus metabolism. It is not actually a vitamin because it can be produced in skin from 7-dehydrocholesterol by UV-B radiation. The product of this transformation is termed cholecalciferol or vitamin D3. This process is self-regulating, preventing vitamin D intoxication even in the setting of large amounts of sunlight exposure. A very similar compound, ergocalciferol (also called vitamin D2) is derived … |
| Databáze: | OpenAIRE |
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