Цитата:
Сообщение от camelot
Версия с нехваткой витамина д3 не накрылась.Может быть нормальный уровень25(oh)d3 при пониженном уровне 1,25(oh)2d3 - проверьте, какой параметр проверялся.
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Насколько мне известно, согласно рекомендациям:
25(OH)D is the major circulating form of vitamin D, with a circulating half-life of 2–3 wk, and it is the best indicator to monitor for vitamin D status (3, 8,
25, 54, 56). The circulating half-life of 1,25(OH)2D is approximately 4 h. It circulates at 1000 times lower concentration than 25(OH)D, and the blood
level is tightly regulated by serum levels of PTH, calcium, and phosphate. Serum 1,25(OH)2D does not reflect vitamin D reserves, and measurement of1,25(OH)2D is not useful for monitoring the vitamin D status of patients. Serum 1,25(OH)2D is frequently either normal or even elevated in those with vitamin D deficiency, due to secondary hyperparathyroidism.
Thus, 1,25(OH)2D measurement does not reflect vitamin D status. Measurement of 1,25(OH)2D is useful in acquired and inherited disorders in the metabolism of 25(OH)D and phosphate, including
chronic kidney disease, hereditary phosphate-losing disorders, oncogenic osteomalacia, pseudovitamin D-deficiency rickets, vitamin D-resistant rickets, as well as chronic granuloma forming disorders such as
sarcoidosis and some lymphomas.
Вроде ничего из вышеперечисленного у пациентки не подозреваем. Или все-таки пробуем найти нефрогенную остеомаляцию?