Abstract
Until the end of the 40’s, the regulation of calcium was deemed to rely upon a simple feedback mechanism and the additional need for calcitonin to maintain serum calcium levels within a very narrow range, thereby representing a “double feedback control”, was understood only later. Vitamin D and vitamin D hormones additionally contribute to this mechanism.
Primary hyperparathyroidism is of clinical relevance in Neurology and even more in hypoparathyroidism and pseudo-hypoparathroidism. The latter lead for the first time to the understanding (in a breed of hen), that an under function of the hormonal system can be due to an inadequate or a non response of the hormonal receptor, which may even occur in the presence of the relevant hormone. In this specific case of pseudo-hypoparathyroidism with hypocalcemia, clinical expression is not dominated by tetanical but by cerebral attacks.
Zusammenfassung
Bis Ende der 40er Jahre war man der Meinung, die Kalziumregulation beruhe auf einem einfachen Feedback- Mechanismus und erst später hat man realisiert, dass, um den Kalziumspiegel in engen Grenzen konstant zu halten, auch noch das Hormon Calcitonin erforderlich ist: „Doppelter-Feedback- Mechanismus“. Ergänzt wird dieser durch das Vitamin D und die D-Hormone.
Klinisch relevant in der Neurologie ist der primäre-Hyperparathyreoidismus, vor allem aber der Hypoparathyreoidismus und der Pseudo-Hypoparathyreoidismus. Bei letzterem hat man zum ersten Mal realisiert (und zwar anhand einer Hühnerrasse), dass eine Unterfunktion des Hormonsystems auch darauf beruhen kann, dass Hormonrezeptoren trotz Vorhandensein eines Hormons nicht auf dieses Hormon ansprechen. Bei diesem angeborenen Pseudo-Hypoparathyreoidismus mit Hypokalzämie stehen nicht tetanische, sondern zerebrale Anfälle im Vordergrund.
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Dambacher, M.A., Schacht, E. & Krämer, G. Parathormon – Vitamin D – D-Hormone – Calcitonin. Z. Epileptol. 19, 176–182 (2006). https://doi.org/10.1007/s10309-006-0215-z
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DOI: https://doi.org/10.1007/s10309-006-0215-z
Key words
- Parathormone
- vitamin D
- D-hormones
- calcitonin
- calciumregulation
- primary hyperparathyreoidisme
- hypoparathyreoidisme
- pseudohypoparathyreoidisme