College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
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Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
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Department of Nephrology, China Medical University Hospital, Taichung, Taiwan
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Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
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Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
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Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
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Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
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Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
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Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
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optimizing serum calcium and phosphorus levels with low-phosphorus diet along with medications including phosphate binders, vitamin D derivatives, and calcimimetics ( 4 ), while patients nonresponsive to maximal medical treatments are considered as refractory
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
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Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Department of Endocrinology and Nephrology, Nordsjællands University Hospital, Hillerød, Denmark
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Center for Neonatal Screening, Department of Congenital Disorders, Statens Serum Institute, Copenhagen, Denmark
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Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
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Steno Diabetes Center Copenhagen, Gentofte, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
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Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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level during hyperinsulinemic conditions could be due to elevated calcium levels ( 19 ). Several other studies, however, showed decreases in PTH during hyperglycemia/hyperinsulinemia that were independent of serum ionized calcium and total plasma calcium
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steroidal substance required by all vertebrates including humans to maintain blood calcium and phosphate within a narrow normal range and thereby support a healthy skeleton, muscle contraction, immune function and optimal cellular functions in many locations
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higher levels of serum calcium, PTH, and larger tumor size than patients with PA. However, some PC cases had normal serum calcium or PTH levels. It is also difficult to identify benign or malignant parathyroid tumors by contrast-enhanced CT scan, cervical
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urinary calcium excretion ( 1 ). Genetic abnormalities causing HPT may lead to complex congenital syndromes or to an isolated endocrinopathy, for which autosomal dominant, autosomal recessive and X-linked modes of inheritance have been described (OMIM
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Department of Clinical Chemistry, Amsterdam Gastroenterology & Metabolism, Amsterdam UMC, University of Amsterdam, Endocrine Laboratory, Amsterdam, Netherlands
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Introduction Parathyroid hormone (PTH) plays a critical role in maintaining adequate serum calcium homeostasis. It increases serum calcium by stimulating bone resorption, promoting phosphate excretion, converting vitamin D to its active form
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, calcium metabolic disorder, hypercalciuria ( 7 , 8 , 9 , 10 ), and acidic urine ( 11 ) and can promote the development of kidney stone disease. Clinically, patients with PA are reported to have a higher incidence of urolithiasis and larger kidney stones
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patients with chronic HP. Furthermore, we attempted to differentiate between HP-related causes, comorbidities and other causes. Lastly, we aimed to assess the awareness of hospital staff by documenting all diagnoses and orders of calcium tests
Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
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Objective
Hypophosphatasia, an inborn error of metabolism characterized by impaired bone mineralization, can affect growth. This study evaluated relationships between anthropometric parameters (height, weight, and body mass index) and clinical manifestations of hypophosphatasia in children.
Design
Data from children (aged <18 years) with hypophosphatasia were analyzed from the observational Global Hypophosphatasia Registry.
Methods
Anthropometric parameters were evaluated by age group (<2 years and ≥2 years) at assessment. The frequency of hypophosphatasia manifestations was compared between children with short stature (< percentile) and those with normal stature.
Results
This analysis included 215 children (54.4% girls). Short stature presented in 16.1% of children aged <2 years and 20.4% of those aged ≥2 years at assessment. Among those with available data (n = 62), height was below the target height (mean: −0.66 standard deviations). Substantial worsening of growth (mean delta height z score: −1.45; delta weight z score: −0.68) occurred before 2 years of age, while in those aged ≥2 years, anthropometric trajectories were maintained (delta height z score: 0.08; delta weight z score: 0.13). Broad-ranging hypophosphatasia manifestations (beyond dental) were observed in most children.
Conclusions
Short stature was not a consistent characteristic of children with hypophosphatasia, but growth impairment was observed in those aged <2 years, indicating that hypophosphatasia might affect growth plate activity during infancy. In addition, a broad range of clinical manifestations occurred in those above and below the third percentile for height, suggesting that height alone may not accurately reflect hypophosphatasia disease burden and that weight is less affected than longitudinal growth.
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First Pavlov State Medical University, St. Petersburg, Russia
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First Pavlov State Medical University, St. Petersburg, Russia
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from being a symptomatic disorder to an asymptomatic one ( 1 ). The reason for this change in presentation among individuals in those countries is the common use of biochemical screening tests that include the serum calcium measurement routinely. As a