A Case of Myeloma with Hypercalcemia Caused by High Serum Concentrations of both Parathyroid Hormone-related Peptide (PTHrP) and Macrophage Inflammatory Protein-1.ALPHA. (MIP-1.ALPHA.)
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概要
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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.
著者
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Nakatani Yuki
Department Of Biological Information Tokyo Institute Of Technology
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Matsumura Mihoko
Department Of Clinical Pharmacology Kyoto Pharmaceutical University
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KASAI Kikuo
Department of Endocrinology
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SHIMIZU Hiroaki
Department of Applied Chemistry, Faculty of Engineering, Osaka University
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Kawagoe Yoshiaki
Department of Endocrinology & Metabolism, Dokkyo Medical University, Japan
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Nakatani Yuki
Department of Diabetes & Endocrinology, Dokkyo Medical University Nikko Medical Center, Japan
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Monden Tsuyoshi
Department of Endocrinology & Metabolism, Dokkyo Medical University, Japan
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Jojima Teruo
Department of Endocrinology & Metabolism, Dokkyo Medical University, Japan
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Tomotsune Takanori
Department of Endocrinology & Metabolism, Dokkyo Medical University, Japan
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Domeki Nozomi
Department of Endocrinology & Metabolism, Dokkyo Medical University, Japan
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