Delayed Hypersensitivity in Primary and Secondary Hyperparathyroidism. Treatment with Active Vitamin D

Summary

The vitamin D endocrine system, besides its traditional role in mineral metabolism, also affects the immune system. A recent study demonstrated that vitamin D supplementation restored a blunted delayed hypersensitivity response (DH) in elderly vitamin D-deficient subjects.

In the present study the DH, as measured by the tuberculin test (PPD), was studied in two groups of patients with a disturbed vitamin D system, i.e. primary hyperparathyroidism (HPT) and secondary HPT due to chronic renal failure.

A significant reduction in DH was found in the patients with chronic renal failure when compared to control subjects (4.1 ± 5.3 vs 12 ± 9.3 mm, p < 0.05) whereas only a non-significant tendency to a reduced DH was seen in the HPT patients (9.5 ± 9.2 mm).

Treatment with alphacalcidol, a synthetic analogue to the active vitamin D metabolite over 3—6 months did not affect the DH in any of the hyperparathyroid patient groups. Thus it seems likely that other factors than vitamin D were involved in their reduced DH response.

Key words

Hyperparathyroidism - Vitamin D - Delayed Hypersensitivity