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Hypercalcemia in undifferentiated leukemia.Possible production of a parathormone-like substance by leukemic cells

✍ Scribed by Richard S. Neiman; Helen C. Li

Publisher: John Wiley and Sons
Year: 1972
Tongue: English
Weight: 271 KB
Volume: 30
Category: Article
ISSN: 0008-543X
DOI: 10.1002/1097-0142(197210)30:4<942::aid-cncr2820300413>3.0.co;2-s

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✦ Synopsis

A 13-year-old boy with a proliferation of undifferentiated cells in bone marrow (undifferentiated leukemia) developed hypercalcemia. Radioimmunoassay of serum during hypercalcemic crisis revealed markedly elevated serum parathormone activity, and f o u r parathyroid glands studied a t autopsy were normal. This is the first case to o u r knowledge in which leukemic cells are implicated in the production of a parathormone-like substance.

YPERCALCEMIA IS A N 1NSII)IOUS AND POTEN-

H tially fatal complication of hematopoietic neoplasms. Its frequency is probably much greater than appreciated because of the general lack of awareness of its existence and because of the relatively nonspecific symptoms caused by this metabolic abnormality. It has generally been thought that the hypercalcemia is the result of the destruction of bone by proliferating leukemic cells.1 Although Jor-dan2 has suggested that it may be due, in some cases, to the production of a parathormonelike substance by the tumor cells, to our knowledge this has not been reported.

The case reported here demonstrates elevated serum parathormone activity in a 13-year-old boy with an undifferentiated leukemia associated with hypercalcemia and hypophosphatemia with normal alkaline phosphatase and creatinine levels. At autopsy, four

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