PMID- 1889513
OWN - NLM
STAT- MEDLINE
DCOM- 19911017
LR  - 20190907
IS  - 0029-0661 (Print)
IS  - 0029-0661 (Linking)
VI  - 67
IP  - 7
DP  - 1991 Jul 20
TI  - [The frequency and mechanisms of urolithiasis in acromegaly].
PG  - 755-63
AB  - It is generally accepted that acromegaly is often associated with hypercalciuria, 
      but there are few reports on the frequency and the mechanisms of urolithiasis. 
      Recently we consecutively experienced 2 cases of acromegaly with urolithiasis, 
      and these experiences made us investigate the association between urolithiasis 
      and acromegaly. Among 18 acromegalies from 1977 to March 1990 (10 males, 8 
      females, 24-64 years old), 13 cases (72%) fulfilled the criteria of 
      hypercalciuria (urinary calcium (u-Ca) greater than or equal to 200 mg/day or 
      u-Ca/urinary creatinine (u-Ca/u-Cr) greater than or equal to 0.15), and 7 cases 
      (39%) suffered from urolithiasis that was diagnosed by KUB (4 cases) or X-ray 
      computed tomography (CT) (3 cases). Especially in the last 2 years, 5 out of 7 
      cases (71%) were complicated with urolithiasis and all 7 cases were associated 
      with hypercalciuria. These results suggest that hypercalciuria and urolithiasis 
      are both much more frequent than previously reported. In 6 cases who were treated 
      by pituitary adenomectomy from 1988-1989 (4 males, 2 females, 24-59 years old), 
      we examined Ca metabolism before and after operation. Before operation, the 
      levels of serum growth hormone (GH), u-Ca (mg/day), u-Ca/u-Cr (in all cases) and 
      plasma somatomedin-C (Sm-C) (in 4 cases) were increased above the normal range. 
      To determine the etiology of hypercalciuria, we performed the oral Ca load test 
      under restriction of Ca (400 mg/day) and P (650 mg/day) intake. The results 
      suggested that the hypercalciuria might be mainly due to the increased absorption 
      of Ca from the intestine (so-called "Absorptive hypercalciuria"). However, the 
      levels of serum vitamin D (Vit. D) metabolites were all within the normal range 
      before operation. After operation, GH and u-Ca/u-Cr (in 5 cases) and u-Ca 
      (mg/day) (in all cases) decreased significantly compared with before operation, 
      and the levels of Sm-C (in all cases), serum 25-(OH)D3, 1 alpha, 25-(OH)2D3 (in 4 
      cases) and 24,25-(OH)2D3 (in 3 cases) were also reduced after operation. 
      Surprisingly, u-Ca and u-Ca/u-Cr normalized only in 4 cases who showed a 
      reduction in 1 alpha, 25-(OH)2D3 levels after operation, although there were no 
      correlations between u-Ca (mg/day) or u-Ca/u-Cr and 1 alpha, 25-(OH)2D3. 
      Significant correlations were found between u-Ca (mg/day) or u-Ca/u-Cr and Sm-C. 
      The parathyroid function evaluated by the rapid Ca infusion test or nephrogenous 
      cyclic adenosine monophosphate (NcAMP) was normal before and after 
      operation.(ABSTRACT TRUNCATED AT 400 WORDS)
FAU - Ieki, Y
AU  - Ieki Y
AD  - First Department of Internal Medicine, Faculty of Medicine, Kanazawa University, 
      Japan.
FAU - Miyakoshi, H
AU  - Miyakoshi H
FAU - Nagai, Y
AU  - Nagai Y
FAU - Bando, Y
AU  - Bando Y
FAU - Usuda, R
AU  - Usuda R
FAU - Miyamoto, I
AU  - Miyamoto I
FAU - Ohsawa, K
AU  - Ohsawa K
FAU - Kobayashi, K
AU  - Kobayashi K
LA  - jpn
PT  - English Abstract
PT  - Journal Article
PL  - Japan
TA  - Nihon Naibunpi Gakkai Zasshi
JT  - Nihon Naibunpi Gakkai zasshi
JID - 0413717
RN  - SY7Q814VUP (Calcium)
SB  - IM
MH  - Acromegaly/*complications/metabolism
MH  - Adult
MH  - Calcium/metabolism/*urine
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Urinary Calculi/*etiology/metabolism
EDAT- 1991/07/20 00:00
MHDA- 1991/07/20 00:01
CRDT- 1991/07/20 00:00
PHST- 1991/07/20 00:00 [pubmed]
PHST- 1991/07/20 00:01 [medline]
PHST- 1991/07/20 00:00 [entrez]
AID - 10.1507/endocrine1927.67.7_755 [doi]
PST - ppublish
SO  - Nihon Naibunpi Gakkai Zasshi. 1991 Jul 20;67(7):755-63. doi: 
      10.1507/endocrine1927.67.7_755.