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June 10, 1974

Tolbutamide and Achondroplasia

Author Affiliations

University of Virginia School of Medicine Charlottesville, Va
Johns Hopkins University School of Medicine Baltimore

JAMA. 1974;228(11):1368. doi:10.1001/jama.1974.03230360016002

To the Editor.—  In MEDICAL NEWS (226:617, 1973), "Tolbutamide Aids Youth With Achondroplasia" reports opinions from an interview with Platon J. Collip, MD.The conclusion drawn by Dr. Collip that achondroplasia is not a primary disorder of bone and cartilage, but a generalized disorder based on glucose intolerance is without fact. There has been no corroboration of glucose intolerance in achondroplasia. In a large number of achondroplastic patients seen by us, glucose tolerance tests have been perfectly normal.In addition, achondroplasia is a dominantly inherited disorder, which strongly argues against an inborn error of metabolism being the primary defect. Rimoin et al have adequately demonstrated that achondroplasia is a quantitative defect in endochondral ossification. Collip did metabolic studies in 1972 on animals thought to be achondroplastic, but these animals, which previously were considered to yield examples of achondroplasia on the basis of histological studies, clearly exhibited a different disorder, not