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STEPHEN J. MARX, ALLEN M. SPIEGEL, EDWARD M. BROWN, DAVID G. GARDNER, ROBERT W. DOWNS, MAURICE ATTIE, ALLEN J. HAMSTRA, HECTOR F. DeLUCA, A Familial Syndrome of Decrease in Sensitivity to 1,25-Dihydroxyvitamin D, The Journal of Clinical Endocrinology & Metabolism, Volume 47, Issue 6, 1 December 1978, Pages 1303–1310, https://doi.org/10.1210/jcem-47-6-1303
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Abstract
Typical features of hereditary vitamin D-dependent (pseudovitamin D-deficient) rickets were observed beginning at ages 20 and 5 months in a brother and sister. Both had calcium malabsorption correctable with high doses of 25-hydroxyvitamin D. During periods of hypocalcemia they both manifested secondary hyperparathyroidism with hypophosphatemia and high serum concentrations of endogenously produced 1,25-dihydroxyvitamin D. In each, normalization of serum calcium concentration and resolution of osteomalacia were obtained with continuous administration of high doses of ergocalciferol or high doses of 1,25-dihydroxycholecalciferol. Chemical features of vitamin D deficiency were corrected in the presence of high circulating concentrations of 1,25-dihydroxyvitamin D2, produced endogenously, or of 1,25-dihydroxyvitamin D3, administered by mouth. Serum concentrations of 25-hydroxyvitamin D2, 25-hydroxyvitamin D3, 24,25-dihydroxyvitamin D, and 1,25-dihydroxyvitamin D were normal in five first degree relatives. We conclude that in these siblings, rickets and osteomalacia resulted from a hereditary decreased sensitivity to 1,25-dihydroxyvitamin D at the intestine and perhaps other vitamin D target tissues.