| Hypercalcemic hyperparathyroidism complicating oncogenic osteomalacia. Effect of successful tumor resection on mineral homeostasis. | |
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MedLine Citation:
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PMID: 3303928 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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I R Reid; S L Teitelbaum; A Dusso; M P Whyte |
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Publication Detail:
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Type: Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; Review |
Journal Detail:
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Title: The American journal of medicine Volume: 83 ISSN: 0002-9343 ISO Abbreviation: Am. J. Med. Publication Date: 1987 Aug |
Date Detail:
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Created Date: 1987-09-18 Completed Date: 1987-09-18 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0267200 Medline TA: Am J Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 350-4 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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RR-00036/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Dihydroxycholecalciferols; 0/Ergocalciferols; 0/Phosphates |
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