Parathyroid Hormone-Related Protein as a Cause of Hypercalcemia in a B-cell Type Malignant Lymphoma

• Published in: Internal Medicine Vol. 31; no. 8; pp. 968 - 972
• Main Authors: WADA, Seiki, KITAMURA, Hideyuki, MATSUURA, Yoshifusa, KATAYAMA, Yasuyuki, OHKAWA, Hidenori, KUGAI, Nobuo, MOTOYOSHI, Kazuo, FUSE, Yusuke, NAGATA, Naokazu
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.08.1992
• Subjects: Aclarubicin - therapeutic use; Adult; Alkaline Phosphatase - blood; Antineoplastic Combined Chemotherapy Protocols; Calcitriol - blood; Cisplatin - therapeutic use; Creatinine - blood; Cyclic AMP - blood; Cytarabine - analogs & derivatives; Cytarabine - therapeutic use; Etoposide - therapeutic use; Glomerular Filtration Rate; Humans; Hydroxycholecalciferols - blood; hydroxyproline; Hydroxyproline - blood; Hypercalcemia - drug therapy; Hypercalcemia - etiology; Ifosfamide - therapeutic use; L-Lactate Dehydrogenase - blood; Lymphoma, B-Cell - complications; Lymphoma, B-Cell - drug therapy; Lymphoma, B-Cell - metabolism; Male; malignancy associated hypercalcemia; osteocalcin (bone GLA protein : BGP); Osteocalcin - blood; Parathyroid Hormone - blood; Parathyroid Hormone-Related Protein; Prednisolone - therapeutic use; Procarbazine - therapeutic use; Proteins - physiology
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.31.968

Hypercalcemia occurred in a patient with non-Hodgkin's (B-cell type) lymphoma when generalized lymphadenopathy developed. Despite low normal plasma parathyroid hormone (PTH), nephrogenous cAMP (NcAMP) was not suppressed, and serum and urine PTH-related protein (PTH-rP) levels were elevated. The plasma level of 1, 25 (OH) 2D was within normal range. The combined chemotherapies successfully reduced the tumor size, serum Ca, PTH-rP, and lactic dehydrogenase. Serum osteocalcin was suppressed while the patient was hypercalcemic, and increased after chemotherapy. In the extract of the tumor tissue obtained post mortem, bioactivity stimulating the production of CAMP in osteoblasts was demonstrated along with the immunoreactive PTH-rP. This is the first report of a B-cell lymphoma producing PTH-rP and its association with humoral hypercalcemia of malignancy. (Internal Medicine 31 : 968-972, 1992)