INCREASED 1,25-(OH)2D2 CONCENTRATION IN A PATIENT WITH MALIGNANCY-ASSOCIATED HYPERCALCEMIA RECEIVING INTRAVENOUS HYPERALIMENTATION INADVERTENTLY SUPPLEMENTED WITH VITAMIN-D(2)

被引:3
作者
SATO, K
IMAKI, T
TORAYA, S
DEMURA, H
TANAKA, M
KASAJIMA, T
TAKEUCHI, A
KOBAYASHI, T
机构
[1] Department of Medicine, Institute of Clinical Endocrinology, Tokyo Women's Medical College, Tokyo
[2] Department of Pathology, Tokyo Women's Medical College, Tokyo
[3] Department of Hygienic Sciences, Kobe Women's College of Pharmacy, Kobe
关键词
HYPERCALCEMIC CRISIS; METASTATIC CALCIFICATION; VITAMIN-D; BISPHOSPHONATE; PAMIDRONATE;
D O I
10.2169/internalmedicine.32.886
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
A 55-year-old patient with hypercalcemic crisis due to gastric carcinoma with bone marrow metastasis was treated with bisphosphonate (pamidronate) and calcitonin. Urinary excretion of parathyroid hormone-related protein (PTHrP) was increased. When normocalcemia had been attained, intravenous hyperalimentation was started, in which 1,000 U vitamin D2 was inadvertently supplemented on days 5-18, On days 15-18, hypercalcemia rapidly recurred, accompanied by markedly increased serum levels of 25-OHD2 (9.1 ng/dl) and 1,25-(OH)2D2 (161 pg/ml). This clinical course suggests that PTHrP, like PTH, stimulated 1alpha-hydroxylase activity and produced excessive 1,25-(OH)2D2. Vitamin D should not be administered to patients with malignancy-associated hypercalcemia, particularly that due to PTHrP-producing tumors.
引用
收藏
页码:886 / 890
页数:5
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