0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Hypercalcemia Associated with Increased Serum Calcitriol Levels in Three Patients with Lymphoma

NEIL A. BRESLAU, M.D.; JAMES L. McGUIRE, M.D.; JOSEPH E. ZERWEKH, Ph.D.; EUGENE P. FRENKEL, M.D.; and CHARLES Y. C. PAK, M.D.
[+] Article and Author Information

Grant support: in part by the U. S. Public Health Service Training Grant 1-T32AM07307; Grants AM26253, AM16061, CA23115, and CA18132 from the National Institutes of Health; General Clinical Research Center Grant MO1-RR00633; Program Project Grant AM20543; the Meadows Foundation; and the Southwestern Medical Foundation-Kinsler Williamson Brown Fund.

Presented in part in April 1982 at the annual meeting of the American Society of Clinical Investigation; Washington D.C.

▸Requests for reprints should be addressed to Neil A. Breslau, M.D.; Department of Internal Medicine, University of Texas Health Science Center at Dallas, Southwestern Medical School, 5323 Harry Hines Boulevard; Dallas, TX 75235.


Dallas, Texas


© 1984 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1984;100(1):1-7. doi:10.7326/0003-4819-100-1-1
Text Size: A A A

A radioreceptor assay for serum 1,25-dihydroxyvitamin D (calcitriol) was used to screen patients with hypercalcemia of malignancy. Three patients with non-Hodgkin's lymphoma and hypercalcemia (serum Ca, 12.0, 13.4, and 13.0 mg/dL, respectively) had increased serum calcitriol levels (56, 72, and 77 pg/mL, respectively; normal, < 50 pg/mL). Elevated levels of calcitriol, an active vitamin D metabolite, occurred in the presence of significant renal impairment (creatinine clearance, 8 to 19 mL/min) and relative parathyroid suppression (serum immunoreactive parathyroid hormone, 17 to 39 µL-eq/ mL; mean value in end-stage renal disease, 182 ± 39 µLeq/mL). Hypercalcemia and excessive serum calcitriol levels responded to glucocorticosteroid therapy. In two patients, the hypercalcemia and increased serum calcitriol level were related to a tumor, but not to the serum immunoreactive parathyroid hormone level. Fractional intestinal 47Ca absorption, measured in one patient, was increased (0.94; normal, < 0.61) and varied directly with the serum calcitriol level. No patient had evidence of sarcoidosis. Hypercalcemia associated with certain lymphomas may be caused by the increased synthesis of calcitriol by lymphoma cells.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)