1,25-Dihydroxyvitamin D-mediated hypercalcemia in oleogranulomatous mastitis (paraffinoma), ameliorated by glucocorticoid administration.
OBJECTIVE
To report a case of oleogranulomatous mastitis (paraffinoma) in which both the hypercalcemia and the inappropriately elevated 1,25-dihydroxyvitamin D [1,25(OH)2D] levels were successfully reduced by administration of prednisone.


METHODS
We describe the clinical, imaging, and laboratory findings in the study patient. Furthermore, we review the relevant literature regarding hypercalcemia in oleogranulomatous mastitis.


RESULTS
A 58-year-old man with oleogranulomatous mastitis (paraffinoma)-related hypercalcemia, renal failure, and inappropriately elevated levels of 1,25(OH)2D presented to our institution. Treatment with prednisone--0.5 mg/kg of body weight or 30 mg daily--for 10 days resulted in a reduction of his serum calcium and 1,25(OH)2D levels to near-normal or normal values and a substantial improvement of his renal function. Nevertheless, the patient ultimately died 11 months later of multiple paraffinoma-related complications.


CONCLUSIONS
In selected cases, treatment with glucocorticoids may offer a temporary relief from paraffinoma-related hypercalcemia until definitive treatment options are feasible.
El Muayed
Malek
M
Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA. m-muayed@northwestern.edu
Costas
Angelo A
AA
Pick
Anthony J
AJ
D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology* / Q000378:metabolism; D008297:Male; D008413:Mastitis / Q000150:complications*; D008875:Middle Aged; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000378:metabolism
D005938:Glucocorticoids; D014807:Vitamin D; C097949:1,25-dihydroxyvitamin D