Hypercalcemia in a Patient with B-Cell Acute Lymphoblastic Leukemia: A Role of Proinflammatory Cytokine
作者:
Hirotaka Fukasawa,
Akihiko Kato,
Yoshihide Fujigaki,
Katsuhiko Yonemura,
Ryuichi Furuya,
Akira Hishida,
期刊:
The American Journal of the Medical Sciences
(OVID Available online 2001)
卷期:
Volume 322,
issue 2
页码: 109-112
ISSN:0002-9629
年代: 2001
出版商: OVID
关键词: Acute lymphoblastic leukemia;Hypercalcemia;Tumor necrosis factor-&agr;;Interleukin-6;Soluble interleukin-2 receptor
数据来源: OVID
摘要:
The complication of hypercalcemia is reported to occur only in 2.5–4.8% of patients with acute lymphoblastic leukemia (ALL). We herein report a 53-year-old female patient with early B-cell ALL, complicated with extreme hypercalcemia (15.2 mg/dL). Bone X-ray revealed osteolytic changes in many locations. Serum 1,25(OH)2vitaminD3and parathyroid hormone(PTH) levels were suppressed below normal ranges on admission. The circulating parathyroid hormone-related protein (PTHrP) value was within a normal range (< 1.1 pmol/L). Serum concentrations of tumor necrosis factor (TNF)-&agr;, interleukin (IL)-6, and soluble IL-2 receptor were increased to 72 pg/ml, 25.3 pg/ml, and 1469 U/ml, respectively. Following the induction chemotherapy, the serum calcium level was promptly normalized accompanied with decreases in serum TNF-&agr;, IL-6 and soluble IL-2 receptor values to 34 pg/ml, 6.35 pg/ml, and 737 U/ml, respectively. Serum PTHrP values remained within detectable levels. To our knowledge, this is the first case of B-cell ALL in a patient who developed hypercalcemia with elevated concentrations of TNF-&agr;, IL-6, and soluble IL-2 receptor, but not related to PTHrP. High circulating proinflammatory cytokines may have contributed to development of ALL-induced osteolysis and hypercalcemia in the present case.
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