186: Treatment of congenital osteogenesis imperfecta with Salmon-Calcitonin and HGH

Abstract

In attempt to improve bone-mineralization and prevent the occurenoe of fractures, 2 infants with congenital osteogenesis imperfecta were treated, within the same period of time, with Salmon-Calcitonin 12–15μU/kg/wk. Treatment was given in two 6 months periods with a period of 6 months in between without treatment. Furthermore at the end of the last period HGH was added to the course (2mg HGH daily/10 days). The daily retention of calcium and phosphate was measured while the patients were on a fixed diet. Furthermore the excretion of hydroxyproline in urine was determined. In the first period of treatment there was a marked increase in calcium and phosphate retention, mostly in the first. A significant decrease in hydroxyproline excretion took place within the first month. In the period without treatment the calcium and phosphate retention decreased initially to pre-treatment values while at the end of this period an increase in retention was observed, which reached the same levels as seen under treatment. In the second period of treatment no further change in calcium or phosphate retention was seen. When HGH was added a marked decrease in retention was noted. The hydroxyproline excretion did not change significantly in the last two periods Conclusion: Treatment with calcitonin results in an increased phosphate and calcium retention and affects collagen turnover as demonstrated in the first period. The observations in the last period-may be explained by formation of calcitonin antibodies, compensatory mechanisms in mineral-metabolism or changes in absorption. No change in the occurence of fractures has hitherto been noticed.