A rare case of chronic lymphocytic leukemia with hypercalcemia induced by elevated parathyroid hormone-related peptides.
Hypercalcemia in malignancies is a frequent complication, mostly affecting patients with solid tumors or multiple myeloma. Calcium elevation is induced by direct bone infiltration of a tumor mass or through calcium liberation from the skeleton by a humoral mediator. The latter mechanism is referred to as humoral hypercalcemia of malignancy (HHM). Frequent mediators of HHM are parathyroid hormone-related peptides (PTHrP). We report a patient with chronic lymphocytic leukemia and hypercalcemia induced by PTHrP. In contrast to solid tumors and myeloma, PTHrP-induced HHM is very rare in low-grad lymphoma including chronic lymphocytic leukemia. Therapeutical approaches consist of cytoreductive treatment and calcium-lowering therapy with bisphosphonates.
Kampfenkel
Tobias
T
Department of Internal Medicine, Knappschaftskrankenhaus, Ruhr-University Bochum, Bochum, Germany. tobias.kampfenkel@rub.de
Baraniskin
A
A
Teschendorf
C
C
Schmiegel
W
W
Massenkeil
G
G
D004164:Diphosphonates / Q000627:therapeutic use; D006801:Humans; D006934:Hypercalcemia / Q000188:drug therapy / Q000209:etiology*; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D044162:Parathyroid Hormone-Related Protein / Q000097:blood*
D004164:Diphosphonates; D044162:Parathyroid Hormone-Related Protein