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Hypercalciuria and Hypercalcemia Complicating Immobilization

Hypercalciuria and Hypercalcemia Complicating Immobilization Abstract In this issue of the Journal (132:560-564, 1978), Rosen and his colleagues reemphasize a phenomenon long known but often forgotten, the dissolution of bone that results from immoblization. They described six boys, between 4 and 16 years old, in whom hypercalcemia and hypercalciuria occurred after bed rest and cast application for fracture of dislocation of weight-bearing bones. Others have found hypercalciuria, with or without hypercalcemia, in association with paralysis,1 severe burns,2 extensive casting for conditions other than fracture,3 the weightless state enjoyed (or at least endured) by astronauts,4 and voluntary bed rest, with5 or without, body spicas.6 In some of these studies, decreased bone density was evident by radiography1 or by gamma scanning6; early and extensive osteoporosis characterized the large series of burn patients described by Evans and Smith.7 Although most subjects have been adults, the few reports involving children suggest that References 1. Whedon GD: Osteoporosis: Atrophy of disuse , in Rodahl K, Nicholson JT, Brown EM (eds): Bone as a Tissue . New York, McGraw-Hill Book Co Inc, 1960, pp 67-99. 2. Berliner BC, Shenker IR, Weinstock MS: Hypercalcemia associated with hypertension due to prolonged immobilization: An unusual complication of extensive burns . Pediatrics 49:92-96, 1972. 3. Stark H, Barnett HL, Edelmann CM Jr: Renal effects of hypercalcuria in immobilized children . Proc Soc Exp Biol Med 118:870-872, 1965. 4. Pace N: Weightlessness: A matter of gravity . N Engl J Med 297:32-37, 1977.Crossref 5. Goldsmith RS, Killian P, Ingbar SH, et al: Effect of phosphate supplementation during immobilization of normal men . Metabolism 18:349-368, 1969.Crossref 6. Donaldson CL, Hulley SB, Vogel JM, et al: The effect of prolonged bed rest on bone mineral . Metabolism 19:1071-1084, 1970.Crossref 7. Evans EB, Smith JR: Bone and joint changes following burns . J Bone Joint Surg Am 41:785-799, 1959. 8. Hulley SB, Vogel JM, Donaldson CL, et al: The effect of supplemental oral phosphate on the bone mineral changes during prolonged bed rest . J Clin Invest 50:2506-2518, 1971.Crossref 9. Lawrence GD, Loeffler RG, Morton LG, et al: Immobilization hypercalcemia: Some new aspects of diagnosis and treatment . J Bone Joint Surg Am 55:87-94, 1973. 10. Burkhart JM, Jowsey J: Parathyroid and thyroid hormones in the development of immobilization osteoporosis . Endocrinology 81:1053-1062, 1967.Crossref 11. Landry M, Fleisch H: Influence of immobilization on bone formation as evaluated by osseous incorporation of tetracyclines . J Bone Joint Surg (Br) 46:764-771, 1964. 12. Heaney RP: Radiocalcium metabolism in disease osteoporosis in man . Am J Med 33:188-200, 1962.Crossref 13. Bassett CAL: Biophysical principles affecting bone structure , in Bourne GH (ed): The Biochemistry and Physiology of Bone , ed 2. New York, Academic Press Inc, 1971, vol 3, pp 1-76. 14. Hantman DA, Vogel JM, Donaldson CL, et al: Attempts to prevent disuse osteoporosis by treatment with calcitonin, longitudinal compression, and supplementary calcium and phosphorus . J Clin Endocrinol Metab 36:845-858, 1973.Crossref 15. Hyman LR, Boner G, Thomas JC, et al: Immobilization hypercalcemia . Am J Dis Child 124:723-727, 1972. 16. Lerman S, Canterbury JM, Reiss E: Parathyroid hormone and the hypercalcemia of immobilization . J Clin Endocrinol Metab 45:425-428, 1977.Crossref 17. Conaway HH, Waite LC, Kenny AD: Immobilization and bone mass in rats: Effects of parathyroidectomy and acetazoleamide . Calcif Tissue Res 11:323-330, 1973.Crossref 18. Lindgren U: The effect of thyroparathyroidectomy on development of disuse osteoporosis in adult rats . Clin Orth 118:251-256, 1975. 19. Wolf A, Chuinard R, Riggins R, et al: Immobilization hypercalcemia: A case report and review of the literature . Clin Orth Rel Res 118:124-129, 1976. 20. Issekutz B, Blizzard JJ, Birkhead NC, et al: Effect of prolonged bed rest on urinary calcium output . J Appl Physiol 21:1013-1020, 1966. 21. Edwards NA, Russell RGG, Hodgkinson A: The effect of oral phosphate in patients with recurrent renal calculus . Br J Urol 37:390-398, 1965.Crossref 22. Suki WN, Yium JJ, Von Minden M, et al: Acute treatment of hypercalcemia with furosemide . N Engl J Med 283:836-840, 1970.Crossref 23. Ede MCM, Burr RG: Circadian rhythm of urinary calcium excretion during immobilization . Aerospace Med 44:495-498, 1973. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Hypercalciuria and Hypercalcemia Complicating Immobilization

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References (26)

Publisher
American Medical Association
Copyright
Copyright © 1978 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1978.02120310017001
Publisher site
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Abstract

Abstract In this issue of the Journal (132:560-564, 1978), Rosen and his colleagues reemphasize a phenomenon long known but often forgotten, the dissolution of bone that results from immoblization. They described six boys, between 4 and 16 years old, in whom hypercalcemia and hypercalciuria occurred after bed rest and cast application for fracture of dislocation of weight-bearing bones. Others have found hypercalciuria, with or without hypercalcemia, in association with paralysis,1 severe burns,2 extensive casting for conditions other than fracture,3 the weightless state enjoyed (or at least endured) by astronauts,4 and voluntary bed rest, with5 or without, body spicas.6 In some of these studies, decreased bone density was evident by radiography1 or by gamma scanning6; early and extensive osteoporosis characterized the large series of burn patients described by Evans and Smith.7 Although most subjects have been adults, the few reports involving children suggest that References 1. Whedon GD: Osteoporosis: Atrophy of disuse , in Rodahl K, Nicholson JT, Brown EM (eds): Bone as a Tissue . New York, McGraw-Hill Book Co Inc, 1960, pp 67-99. 2. Berliner BC, Shenker IR, Weinstock MS: Hypercalcemia associated with hypertension due to prolonged immobilization: An unusual complication of extensive burns . Pediatrics 49:92-96, 1972. 3. Stark H, Barnett HL, Edelmann CM Jr: Renal effects of hypercalcuria in immobilized children . Proc Soc Exp Biol Med 118:870-872, 1965. 4. Pace N: Weightlessness: A matter of gravity . N Engl J Med 297:32-37, 1977.Crossref 5. Goldsmith RS, Killian P, Ingbar SH, et al: Effect of phosphate supplementation during immobilization of normal men . Metabolism 18:349-368, 1969.Crossref 6. Donaldson CL, Hulley SB, Vogel JM, et al: The effect of prolonged bed rest on bone mineral . Metabolism 19:1071-1084, 1970.Crossref 7. Evans EB, Smith JR: Bone and joint changes following burns . J Bone Joint Surg Am 41:785-799, 1959. 8. Hulley SB, Vogel JM, Donaldson CL, et al: The effect of supplemental oral phosphate on the bone mineral changes during prolonged bed rest . J Clin Invest 50:2506-2518, 1971.Crossref 9. Lawrence GD, Loeffler RG, Morton LG, et al: Immobilization hypercalcemia: Some new aspects of diagnosis and treatment . J Bone Joint Surg Am 55:87-94, 1973. 10. Burkhart JM, Jowsey J: Parathyroid and thyroid hormones in the development of immobilization osteoporosis . Endocrinology 81:1053-1062, 1967.Crossref 11. Landry M, Fleisch H: Influence of immobilization on bone formation as evaluated by osseous incorporation of tetracyclines . J Bone Joint Surg (Br) 46:764-771, 1964. 12. Heaney RP: Radiocalcium metabolism in disease osteoporosis in man . Am J Med 33:188-200, 1962.Crossref 13. Bassett CAL: Biophysical principles affecting bone structure , in Bourne GH (ed): The Biochemistry and Physiology of Bone , ed 2. New York, Academic Press Inc, 1971, vol 3, pp 1-76. 14. Hantman DA, Vogel JM, Donaldson CL, et al: Attempts to prevent disuse osteoporosis by treatment with calcitonin, longitudinal compression, and supplementary calcium and phosphorus . J Clin Endocrinol Metab 36:845-858, 1973.Crossref 15. Hyman LR, Boner G, Thomas JC, et al: Immobilization hypercalcemia . Am J Dis Child 124:723-727, 1972. 16. Lerman S, Canterbury JM, Reiss E: Parathyroid hormone and the hypercalcemia of immobilization . J Clin Endocrinol Metab 45:425-428, 1977.Crossref 17. Conaway HH, Waite LC, Kenny AD: Immobilization and bone mass in rats: Effects of parathyroidectomy and acetazoleamide . Calcif Tissue Res 11:323-330, 1973.Crossref 18. Lindgren U: The effect of thyroparathyroidectomy on development of disuse osteoporosis in adult rats . Clin Orth 118:251-256, 1975. 19. Wolf A, Chuinard R, Riggins R, et al: Immobilization hypercalcemia: A case report and review of the literature . Clin Orth Rel Res 118:124-129, 1976. 20. Issekutz B, Blizzard JJ, Birkhead NC, et al: Effect of prolonged bed rest on urinary calcium output . J Appl Physiol 21:1013-1020, 1966. 21. Edwards NA, Russell RGG, Hodgkinson A: The effect of oral phosphate in patients with recurrent renal calculus . Br J Urol 37:390-398, 1965.Crossref 22. Suki WN, Yium JJ, Von Minden M, et al: Acute treatment of hypercalcemia with furosemide . N Engl J Med 283:836-840, 1970.Crossref 23. Ede MCM, Burr RG: Circadian rhythm of urinary calcium excretion during immobilization . Aerospace Med 44:495-498, 1973.

Journal

American Journal of Diseases of Children – American Medical Association

Published: Jun 1, 1978

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