title: Vitamin D-mediated hypercalcemia in multicentric Castleman's disease.
abstract: Multicentric Castleman's disease (MCD) is a rare lymphoproliferative disorder, which represents various symptoms caused by the hyperproduction of interleukin-6 (IL-6). However, case studies of MCD accompanied by hypercalcemia have rarely been reported thus far. A 78-year-old male had generalized fatigue, and his laboratory data revealed elevated serum calcium (Ca) and 1,25-dihydroxyvitamin D [1,25(OH)2D] levels (11.5 mg/dl and 80 pg/ml, respectively), while the serum intact parathyroid hormone level was low (4 pg/ml). Computed tomography showed multicentric lymphadenopathy. The serum IL-6 level was elevated (20.7 pg/ml), and pathological examination of a supraclavicular lymph node specimen led us to diagnose MCD. Moreover, immunostaining analysis showed that vitamin D-activating enzyme 25-hydroxyvitamin D 1-alpha-hydroxylase was expressed in lymph node macrophages. Prednisolone treatment improved the hypercalcemia and decreased the levels of 1,25(OH)2D and IL-6. We first reported a case of vitamin D-mediated hypercalcemia in MCD.
authors.affiliation: Department of Internal Medicine 1, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, 693-8501, Japan.
authors.forename: Ken-Ichiro
authors.initials: KI
authors.lastname: Tanaka
authors.affiliation: Department of Internal Medicine 1, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, 693-8501, Japan. ippei.k@med.shimane-u.ac.jp.
authors.forename: Ippei
authors.initials: I
authors.lastname: Kanazawa
authors.affiliation: Department of Internal Medicine 1, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, 693-8501, Japan.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Miyake
authors.affiliation: Department of Laboratory Medicine, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, 693-8501, Japan.
authors.forename: Shozo
authors.initials: S
authors.lastname: Yano
authors.affiliation: Functional Pathology Unit, Department of Pathology, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, 693-8501, Japan.
authors.forename: Chika
authors.initials: C
authors.lastname: Amano
authors.affiliation: Organ Pathology Unit, Department of Pathology, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, 693-8501, Japan.
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Ishikawa
authors.affiliation: Organ Pathology Unit, Department of Pathology, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, 693-8501, Japan.|Laboratory of Surgical Pathology, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, 693-8501, Japan.
authors.forename: Riruke
authors.initials: R
authors.lastname: Maruyama
authors.affiliation: Department of Internal Medicine 1, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, 693-8501, Japan.
authors.forename: Toshitsugu
authors.initials: T
authors.lastname: Sugimoto
mesh_terms: D000368:Aged; D005871:Castleman Disease / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000139:chemically induced* / Q000188:drug therapy; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D011239:Prednisolone / Q000008:administration & dosage; D014807:Vitamin D / Q000008:administration & dosage* / Q000009:adverse effects* / Q000031:analogs & derivatives / Q000097:blood
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D; C097949:1,25-dihydroxyvitamin D; D011239:Prednisolone
keywords: 25-Hydroxyvitamin D 1-alpha-hydroxylase; Castleman disease; Hypercalcemia; Prednisolone; Vitamin D