고칼슘혈증 및 골용해성 병변을 동반한 급성 골수성 백혈병 1 예

A case of hypercalcemia and osteolytic bone lesions complicating acute myelogenous leukemia, is described with review of literature. The patient was admitted with a 15-day history of nausea, vomiting, and multiple joint pain. On admission, laboratory studies revealed Hb 10.6g/dL, Hct 31.7%, WHC 2.100/mm³, Platelet 93.000/mm³, BUN 32.6mg/dL, Creatinine 2.8mg/dL, serum calcium 13.3mg/dL, serum phosphate 3.1mg/dL, serum radioimmuno reactive parathyroid hormone 0.17ng/dL. Bone marrow study showed blast as much as 84%. Simple X- ray showed multiple scattered osteolytic bone lesions on skull and pelvis. The patient was treated with Daunorubicin 45mg/M² to 3 day, Cytarabine 100mg/ M² to 7 day as remission induction chemotherapy, and achieved normal range of serum calcium and renal function with complete remission hematologically, and received 3 times of consolidation chemotherapy thereafter. The patient was re-adimitted with headache, nausea, intermittent seizure, and loss of conscious- ness during follow-up. With CNS involvement of the leukemic cell by cerebrospinal fluid(CSF) study, laboratory studies showed recurrence of the AML and hypercalcemia. He was treated with emergency radiotherapy(total 2.400cGy) and chemotherapy. He was improved symptomatically and hypercalcemia was disappeared, but the bone marrow aspiration revealed incomplete remission (blast 10%). The patient with his family refused further therapy, and discharged. He died about 1 month after discharge