Document Detail

Accelerated bone formation causing profound hypocalcemia in acute leukemia.
MedLine Citation:
PMID:  3461737     Owner:  NLM     Status:  MEDLINE    
A patient with acute monocytic leukemia and fibrosis presented with severe hypocalcemia producing tetany, myocardial failure, and ventricular tachycardia with torsades de pointes configuration. Hypophosphatemia, hypomagnesemia, an elevated alkaline phosphatase level, and osteosclerosis were also present. Bone marrow biopsy samples showed fibrosis and thickened bony trabeculae lined with large osteoblasts. Tetracycline labeling showed an increased rate of calcification. Complete remission of the leukemia and fibrosis was achieved with a single 3-week course of low-dose cytarabine and hydroxyurea, with resolution of the hypocalcemia and hypophosphatemia. Calcitriol and etidronate disodium were also administered. The calculated left ventricular ejection fraction increased from 15% to 55% with correction of the hypocalcemia. The hypocalcemia and hypophosphatemia in this patient probably resulted from accelerated bone formation stimulated by the leukemic cells. The high dose of calcitriol that this patient received may have contributed to the remission of the leukemia.
D P Schenkein; W C O'Neill; J Shapiro; K B Miller
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Annals of internal medicine     Volume:  105     ISSN:  0003-4819     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  1986 Sep 
Date Detail:
Created Date:  1986-09-25     Completed Date:  1986-09-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  375-8     Citation Subset:  AIM; IM    
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MeSH Terms
Bone Development*
Hypocalcemia / etiology*
Leukemia, Myeloid, Acute / blood,  complications*,  physiopathology
Osteoblasts / physiology
Phosphates / blood
Shock, Cardiogenic / etiology
Tachycardia / etiology
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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