Document Detail


Hypercalcemic hyperparathyroidism complicating oncogenic osteomalacia. Effect of successful tumor resection on mineral homeostasis.
MedLine Citation:
PMID:  3303928     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Described herein is a case of oncogenic osteomalacia that ran a course of at least 16 years before curative resection of a mixed mesenchymal tumor. Hypercalcemic hyperparathyroidism developed in the patient, and review of the literature indicated that this occurs in about 10 percent of reported cases. Changes in serum parathyroid hormone levels with and without phosphate supplement therapy and before and after tumor resection suggested that both the high intake of phosphate and the effect of the neoplasm on vitamin D bioactivation engendered the parathyroid overactivity. Despite marked hyperparathyroidism, serum 1,25-dihydroxyvitamin D levels were subnormal preoperatively but showed a sevenfold increase within 48 hours of tumor resection. Thereafter, a gradual increase in the maximal tubular reabsorption of phosphate occurred during several months. Biopsy of the iliac crest confirmed that tumor removal was followed by resolution of osteomalacia, but there was no accompanying increase in vertebral mineral density as assessed by quantitative computed tomography or in total-body bone mineral as measured with dual-photon absorptiometry. The findings presented are consistent with secretion by the tumor of a factor with a short half-life that is potent enough to inhibit renal 25-hydroxyvitamin D-1 alpha-hydroxylase despite hyperparathyroidism. The resulting subnormal circulating 1,25-dihydroxyvitamin D levels may have secondarily contributed to decreased renal tubular reabsorption of phosphate.
Authors:
I R Reid; S L Teitelbaum; A Dusso; M P Whyte
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  The American journal of medicine     Volume:  83     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  1987 Aug 
Date Detail:
Created Date:  1987-09-18     Completed Date:  1987-09-18     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  350-4     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Chronic Disease
Combined Modality Therapy
Dihydroxycholecalciferols / blood
Ergocalciferols / therapeutic use
Female
Homeostasis*
Humans
Hypercalcemia / blood,  drug therapy,  etiology*
Hyperparathyroidism, Secondary / blood,  drug therapy,  etiology*
Mesenchymoma / blood,  complications*,  surgery
Middle Aged
Osteomalacia / blood,  complications*,  etiology,  surgery
Phosphates / blood,  therapeutic use
Soft Tissue Neoplasms / blood,  complications*,  surgery
Grant Support
ID/Acronym/Agency:
RR-00036/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Dihydroxycholecalciferols; 0/Ergocalciferols; 0/Phosphates

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


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