Calcitriol deficiency in idiopathic juvenile osteoporosis
H. K. Marder, R. C. Tsang, G. Hug and A. C. Crawford
Low plasma calcitriol (1,25-dihydroxycholecalciferol) and normal serum
calcifediol (25-hydroxycholecalciferol) levels were noted during the
evaluation of an 11-year-old girl with diffuse osteoporosis and pathologic
fractures. The onset of osteoporosis prior to puberty and the
characteristic metaphyseal location of the fractures supported the
diagnosis of idiopathic juvenile osteoporosis (IJO). Treatment with
calcitriol, 1.0 microgram daily, was associated with bone mineral accretion
and a diminished incidence of fractures. Plasma calcitriol levels returned
to normal when the disease resolved following puberty. This experience
suggests a relationship between calcitriol deficiency and the pathogenesis
of IJO.
