A Case of Myeloma with Hypercalcemia Caused by High Serum Concentrations of both Parathyroid Hormone-related Peptide (PTHrP) and Macrophage Inflammatory Protein-1α (MIP-1α)
A 62-year-old woman was admitted with dry mouth, general fatigue, and severe back pain. Biochemistry examination showed extreme hypercalcemia (21.2 mg/dL). Bone marrow examination was negative, but needle biopsy of a metastatic lung tumor revealed abnormal plasma cells; thus, multiple myeloma stage...
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| Veröffentlicht in: | Internal Medicine 2011, Vol.50(24), pp.2993-2996 |
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| container_title | Internal Medicine |
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| creator | Shimizu, Hiroaki Monden, Tsuyoshi Tomotsune, Takanori Nakatani, Yuki Domeki, Nozomi Matsumura, Mihoko Jojima, Teruo Kawagoe, Yoshiaki Kasai, Kikuo |
| description | A 62-year-old woman was admitted with dry mouth, general fatigue, and severe back pain. Biochemistry examination showed extreme hypercalcemia (21.2 mg/dL). Bone marrow examination was negative, but needle biopsy of a metastatic lung tumor revealed abnormal plasma cells; thus, multiple myeloma stage III-A was finally diagnosed. Serum concentrations of both parathyroid hormone-related peptide (PTHrP) and macrophage inflammatory protein-1α (MIP-1α) were markedly elevated (PTHrP 7.2 pmol/L, normal |
| doi_str_mv | 10.2169/internalmedicine.50.6096 |
| format | Article |
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Biochemistry examination showed extreme hypercalcemia (21.2 mg/dL). Bone marrow examination was negative, but needle biopsy of a metastatic lung tumor revealed abnormal plasma cells; thus, multiple myeloma stage III-A was finally diagnosed. Serum concentrations of both parathyroid hormone-related peptide (PTHrP) and macrophage inflammatory protein-1α (MIP-1α) were markedly elevated (PTHrP 7.2 pmol/L, normal <1.1 pmol/L; MIP-1α 84.9 pg/mL, normal <46.9 pg/mL). Her myeloma appeared to have simultaneously caused two mechanisms producing hypercalcemia: humoral hypercalcemia of malignancy (HHM) by PTHrP and local osteolytic hypercalcemia (LOH) by MIP-1α. Therefore, the combination of two calcium-modulating abnormalities likely aggravated her hypercalcemia.</description><identifier>ISSN: 0918-2918</identifier><identifier>EISSN: 1349-7235</identifier><identifier>DOI: 10.2169/internalmedicine.50.6096</identifier><identifier>PMID: 22185991</identifier><language>eng</language><publisher>Japan: The Japanese Society of Internal Medicine</publisher><subject><![CDATA[Antineoplastic Combined Chemotherapy Protocols - administration & dosage ; Bone Density Conservation Agents - administration & dosage ; Calcitonin - administration & dosage ; Calcium - blood ; Chemokine CCL3 - blood ; Dexamethasone - administration & dosage ; Diphosphonates - administration & dosage ; Doxorubicin - administration & dosage ; Female ; Humans ; humoral hypercalcemia of malignancy ; Hypercalcemia - blood ; Hypercalcemia - drug therapy ; Hypercalcemia - etiology ; local osteolytic hypercalcemia ; macrophage inflammatory protein-1α ; Middle Aged ; Multiple Myeloma - blood ; Multiple Myeloma - complications ; Multiple Myeloma - diagnosis ; Multiple Myeloma - drug therapy ; Pamidronate ; parathyroid hormone-related peptide ; Parathyroid Hormone-Related Protein - blood ; Vincristine - administration & dosage]]></subject><ispartof>Internal Medicine, 2011, Vol.50(24), pp.2993-2996</ispartof><rights>2011 by The Japanese Society of Internal Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1883,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22185991$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shimizu, Hiroaki</creatorcontrib><creatorcontrib>Monden, Tsuyoshi</creatorcontrib><creatorcontrib>Tomotsune, Takanori</creatorcontrib><creatorcontrib>Nakatani, Yuki</creatorcontrib><creatorcontrib>Domeki, Nozomi</creatorcontrib><creatorcontrib>Matsumura, Mihoko</creatorcontrib><creatorcontrib>Jojima, Teruo</creatorcontrib><creatorcontrib>Kawagoe, Yoshiaki</creatorcontrib><creatorcontrib>Kasai, Kikuo</creatorcontrib><title>A Case of Myeloma with Hypercalcemia Caused by High Serum Concentrations of both Parathyroid Hormone-related Peptide (PTHrP) and Macrophage Inflammatory Protein-1α (MIP-1α)</title><title>Internal Medicine</title><addtitle>Intern. Med.</addtitle><description>A 62-year-old woman was admitted with dry mouth, general fatigue, and severe back pain. Biochemistry examination showed extreme hypercalcemia (21.2 mg/dL). Bone marrow examination was negative, but needle biopsy of a metastatic lung tumor revealed abnormal plasma cells; thus, multiple myeloma stage III-A was finally diagnosed. Serum concentrations of both parathyroid hormone-related peptide (PTHrP) and macrophage inflammatory protein-1α (MIP-1α) were markedly elevated (PTHrP 7.2 pmol/L, normal <1.1 pmol/L; MIP-1α 84.9 pg/mL, normal <46.9 pg/mL). Her myeloma appeared to have simultaneously caused two mechanisms producing hypercalcemia: humoral hypercalcemia of malignancy (HHM) by PTHrP and local osteolytic hypercalcemia (LOH) by MIP-1α. Therefore, the combination of two calcium-modulating abnormalities likely aggravated her hypercalcemia.</description><subject>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</subject><subject>Bone Density Conservation Agents - administration & dosage</subject><subject>Calcitonin - administration & dosage</subject><subject>Calcium - blood</subject><subject>Chemokine CCL3 - blood</subject><subject>Dexamethasone - administration & dosage</subject><subject>Diphosphonates - administration & dosage</subject><subject>Doxorubicin - administration & dosage</subject><subject>Female</subject><subject>Humans</subject><subject>humoral hypercalcemia of malignancy</subject><subject>Hypercalcemia - blood</subject><subject>Hypercalcemia - drug therapy</subject><subject>Hypercalcemia - etiology</subject><subject>local osteolytic hypercalcemia</subject><subject>macrophage inflammatory protein-1α</subject><subject>Middle Aged</subject><subject>Multiple Myeloma - blood</subject><subject>Multiple Myeloma - complications</subject><subject>Multiple Myeloma - diagnosis</subject><subject>Multiple Myeloma - drug therapy</subject><subject>Pamidronate</subject><subject>parathyroid hormone-related peptide</subject><subject>Parathyroid Hormone-Related Protein - blood</subject><subject>Vincristine - administration & dosage</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkd1u1DAQhS0EokvhFZDvaC-y-Cd_vqxWQFbqqpEo19HEmTReJfZiO6ryUki8CM9Eqi694GZmNPrmSHMOIZSzreC5-mxsRG9hnLAz2ljcZmybM5W_IhsuU5UUQmavyYYpXiZiLRfkXQhHxmRZKPGWXAjBy0wpviG_bugOAlLX08OCo5uAPpo40Go5odcwapwMrMgcsKPtQivzMNDv6OeJ7pzVaKOHaJwNTwqtWy9rWDfD4p3paOX85CwmHkeIq0CNp2g6pFf1feXrawq2owfQ3p0GeEC6t_0I0wTR-YXW3kU0NuF_ftOrw75-Gq7fkzc9jAE_nPsl-fH1y_2uSm7vvu13N7fJUbI8Jj32muesVFwipLpLCynSroMMsrZoOyh6YLkuZAqyFb2CUvT9alnBkemyzbm8JJ-edU_e_ZwxxGYyQeM4gkU3h0ZxkYoiK8uV_Hgm53aNozl5M4Ffmn8Wr8DdM3AMcX3yBQAfjR6x-T_LJmONSM9VKCVfSD2Ab9DKvxYzosU</recordid><startdate>20110101</startdate><enddate>20110101</enddate><creator>Shimizu, Hiroaki</creator><creator>Monden, Tsuyoshi</creator><creator>Tomotsune, Takanori</creator><creator>Nakatani, Yuki</creator><creator>Domeki, Nozomi</creator><creator>Matsumura, Mihoko</creator><creator>Jojima, Teruo</creator><creator>Kawagoe, Yoshiaki</creator><creator>Kasai, Kikuo</creator><general>The Japanese Society of Internal Medicine</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>20110101</creationdate><title>A Case of Myeloma with Hypercalcemia Caused by High Serum Concentrations of both Parathyroid Hormone-related Peptide (PTHrP) and Macrophage Inflammatory Protein-1α (MIP-1α)</title><author>Shimizu, Hiroaki ; Monden, Tsuyoshi ; Tomotsune, Takanori ; Nakatani, Yuki ; Domeki, Nozomi ; Matsumura, Mihoko ; Jojima, Teruo ; Kawagoe, Yoshiaki ; Kasai, Kikuo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-j306t-fefc1608913ea4cd47324dda5a5b7bda7fa06c734a3b2f9a82ff23571e0c8b613</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</topic><topic>Bone Density Conservation Agents - administration & dosage</topic><topic>Calcitonin - administration & dosage</topic><topic>Calcium - blood</topic><topic>Chemokine CCL3 - blood</topic><topic>Dexamethasone - administration & dosage</topic><topic>Diphosphonates - administration & dosage</topic><topic>Doxorubicin - administration & dosage</topic><topic>Female</topic><topic>Humans</topic><topic>humoral hypercalcemia of malignancy</topic><topic>Hypercalcemia - blood</topic><topic>Hypercalcemia - drug therapy</topic><topic>Hypercalcemia - etiology</topic><topic>local osteolytic hypercalcemia</topic><topic>macrophage inflammatory protein-1α</topic><topic>Middle Aged</topic><topic>Multiple Myeloma - blood</topic><topic>Multiple Myeloma - complications</topic><topic>Multiple Myeloma - diagnosis</topic><topic>Multiple Myeloma - drug therapy</topic><topic>Pamidronate</topic><topic>parathyroid hormone-related peptide</topic><topic>Parathyroid Hormone-Related Protein - blood</topic><topic>Vincristine - administration & dosage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shimizu, Hiroaki</creatorcontrib><creatorcontrib>Monden, Tsuyoshi</creatorcontrib><creatorcontrib>Tomotsune, Takanori</creatorcontrib><creatorcontrib>Nakatani, Yuki</creatorcontrib><creatorcontrib>Domeki, Nozomi</creatorcontrib><creatorcontrib>Matsumura, Mihoko</creatorcontrib><creatorcontrib>Jojima, Teruo</creatorcontrib><creatorcontrib>Kawagoe, Yoshiaki</creatorcontrib><creatorcontrib>Kasai, Kikuo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Internal Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shimizu, Hiroaki</au><au>Monden, Tsuyoshi</au><au>Tomotsune, Takanori</au><au>Nakatani, Yuki</au><au>Domeki, Nozomi</au><au>Matsumura, Mihoko</au><au>Jojima, Teruo</au><au>Kawagoe, Yoshiaki</au><au>Kasai, Kikuo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Case of Myeloma with Hypercalcemia Caused by High Serum Concentrations of both Parathyroid Hormone-related Peptide (PTHrP) and Macrophage Inflammatory Protein-1α (MIP-1α)</atitle><jtitle>Internal Medicine</jtitle><addtitle>Intern. Med.</addtitle><date>2011-01-01</date><risdate>2011</risdate><volume>50</volume><issue>24</issue><spage>2993</spage><epage>2996</epage><pages>2993-2996</pages><issn>0918-2918</issn><eissn>1349-7235</eissn><abstract>A 62-year-old woman was admitted with dry mouth, general fatigue, and severe back pain. Biochemistry examination showed extreme hypercalcemia (21.2 mg/dL). Bone marrow examination was negative, but needle biopsy of a metastatic lung tumor revealed abnormal plasma cells; thus, multiple myeloma stage III-A was finally diagnosed. Serum concentrations of both parathyroid hormone-related peptide (PTHrP) and macrophage inflammatory protein-1α (MIP-1α) were markedly elevated (PTHrP 7.2 pmol/L, normal <1.1 pmol/L; MIP-1α 84.9 pg/mL, normal <46.9 pg/mL). Her myeloma appeared to have simultaneously caused two mechanisms producing hypercalcemia: humoral hypercalcemia of malignancy (HHM) by PTHrP and local osteolytic hypercalcemia (LOH) by MIP-1α. Therefore, the combination of two calcium-modulating abnormalities likely aggravated her hypercalcemia.</abstract><cop>Japan</cop><pub>The Japanese Society of Internal Medicine</pub><pmid>22185991</pmid><doi>10.2169/internalmedicine.50.6096</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Antineoplastic Combined Chemotherapy Protocols - administration & dosage Bone Density Conservation Agents - administration & dosage Calcitonin - administration & dosage Calcium - blood Chemokine CCL3 - blood Dexamethasone - administration & dosage Diphosphonates - administration & dosage Doxorubicin - administration & dosage Female Humans humoral hypercalcemia of malignancy Hypercalcemia - blood Hypercalcemia - drug therapy Hypercalcemia - etiology local osteolytic hypercalcemia macrophage inflammatory protein-1α Middle Aged Multiple Myeloma - blood Multiple Myeloma - complications Multiple Myeloma - diagnosis Multiple Myeloma - drug therapy Pamidronate parathyroid hormone-related peptide Parathyroid Hormone-Related Protein - blood Vincristine - administration & dosage |
| title | A Case of Myeloma with Hypercalcemia Caused by High Serum Concentrations of both Parathyroid Hormone-related Peptide (PTHrP) and Macrophage Inflammatory Protein-1α (MIP-1α) |
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