Severe hypercalcaemia in B-cell lymphoma: combined effects of PTH-rP, IL-6 and TNF

Hypercalcaemia as the only manifestation of B-cell lymphoma is seen very rarely. Its pathophysiology is heterogenous and not well understood. We report a 73-year-old man who presented with severe hypercalcaemia before any signs of malignancy became evident. He was diagnosed with a B-cell lymphoma on...

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Bibliographic Details
Published in:Postgraduate medical journal 1999-11, Vol.75 (889), p.672-674
Main Authors: Daroszewska, Anna, Bucknall, Roger C, Chu, Patrick, Fraser, William D
Format: Article
Language:English
Subjects:
Aged
Antineoplastic Combined Chemotherapy Protocols - administration & dosage
Biological and medical sciences
Bone marrow
Bone Marrow Cells
C-Reactive Protein - analysis
C-Reactive Protein - metabolism
Cyclophosphamide - administration & dosage
Cytokines
Doxorubicin - administration & dosage
Gangrene
Hematology
Humans
hypercalcaemia
Hypercalcemia - drug therapy
Hypercalcemia - etiology
Hypercalcemia - metabolism
interleukin-6
Interleukin-6 - blood
Interleukin-6 - metabolism
Investigative techniques, diagnostic techniques (general aspects)
Lymphoma
Lymphoma, B-Cell - complications
Lymphoma, B-Cell - drug therapy
Lymphoma, B-Cell - metabolism
Male
Medical sciences
Multiple myeloma
Neoplasm Proteins - metabolism
Osteoarticular system. Muscles
Osteoblasts - pathology
Osteoclasts - pathology
Parathyroid Hormone-Related Protein
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
Prednisone - administration & dosage
Proteins - metabolism
Short Report
Tumor Necrosis Factor-alpha - analysis
Tumor Necrosis Factor-alpha - metabolism
Tumor necrosis factor-TNF
tumour necrosis factor
Vincristine - administration & dosage
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Summary:Hypercalcaemia as the only manifestation of B-cell lymphoma is seen very rarely. Its pathophysiology is heterogenous and not well understood. We report a 73-year-old man who presented with severe hypercalcaemia before any signs of malignancy became evident. He was diagnosed with a B-cell lymphoma on bone marrow trephine biopsy. The hypercalcaemia was associated with high plasma concentrations of parathyroid-hormone-related protein, interleukin-6 and tumour necrosis factor. Our patient had markedly increased osteoclast and osteoblast activity as a result of synergistic effects between these factors, with consequent severe hypercalcaemia. This is the first reported example of such combined effects of these factors in humans.
ISSN:0032-5473
1469-0756
DOI:10.1136/pgmj.75.889.672