[Hypercalcemia in coexistent parathyroid adenoma and multiple myeloma. Problems of differential diagnosis].
In a chance observation, a 74-year-old woman was found to have hypercalcaemia (3.0 mmol/l) and multiple skeletal osteolyses. A diagnosis of multiple myeloma was made after the demonstration of paraproteins in serum (IgG-kappa) and a 10% proportion of plasma cells in a pelvic crest biopsy. Oral chemotherapy with melphalan and prednisone failed to alter the calcium level. Simultaneous increase in alkaline phosphatase and reduction in serum phosphate concentration led to further tests: determination of peripheral venous parathormone concentration, ultrasound examination of the neck, thallium-technetium subtraction scintigraphy and selective venous parathormone measurements. The results demonstrated the coexistence of primary hyperparathyroidism. The calcium level became normal after surgical removal of a parathyroid adenoma.
Schneider
W
W
Abteilung für Hämatologie, Universität Düsseldorf.
Thomas
M
M
D000236:Adenoma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology*; D006961:Hyperparathyroidism / Q000150:complications / Q000175:diagnosis / Q000209:etiology; D009101:Multiple Myeloma / Q000150:complications* / Q000175:diagnosis; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000209:etiology; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D011859:Radiography; D014463:Ultrasonography
D010281:Parathyroid Hormone
Hypercalcämie bei Koinzidenz eines Nebenschilddrüsenadenoms und eines multiplen Myeloms. Differentialdiagnostische Probleme.