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November 1974

Vitamin D-Resistant Rickets and Parathyroid Adenomas: Renal Transport of Phosphate

Author Affiliations

From the departments of pediatrics (Drs. Talwalkar, Musgrave, Buist, and Robert A. Campbell) and pediatric surgery (Dr. John R. Campbell), University of Oregon Medical School, Portland.

Am J Dis Child. 1974;128(5):704-708. doi:10.1001/archpedi.1974.02110300114017

Autonomous hyperparathyroidism in vitamin D-resistant rickets is very rare. A 15-year-old girl with vitamin D-resistant rickets developed persistent hypercalcemia, hypertension, and inability to concentrate urine. Serum parathormone levels were elevated and were not substantially suppressed by calcium infusion. The renal tubular defect in phosphate reabsorption was unaltered during hyperparathyroidism and after removal of 3¾ of the parathyroid glands. The surgical specimen showed two parathyroid adenomas that were confirmed histologically. These findings support the concept that the primary defect in this disease is in renal tubular reabsorption of phosphate.

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