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Journal of Clinical Endocrinology & Metabolism, Vol 60, 29-33, Copyright © 1985 by Endocrine Society

ARTICLES

Elevations in circulating 1,25-dihydroxyvitamin D in three patients with lymphoma-associated hypercalcemia

N Rosenthal, KL Insogna, JW Godsall, L Smaldone, JA Waldron and AF Stewart

Three patients with hypercalcemia associated with malignant lymphoma and elevations in plasma 1,25-dihydroxyvitamin D [1,25-(OH)2D] are described. In addition to the elevation of circulating 1,25-(OH)2D, these three patients were characterized by suppressed immunoreactive PTH levels and urinary cAMP excretion, elevated fasting urinary excretion of calcium, and absence of adenylate cyclase-stimulating activity in the tumor extracts. Bone marrow biopsy and skeletal radionuclide scans were negative for lymphoma in two patients. Surgical excision of a solitary splenic lymphoma in one patient and medical therapy in another patient resulted in rapid normalization of the serum calcium and plasma 1,25-(OH)2D levels. These findings confirm an earlier observation that elevated plasma levels of 1,25-(OH)2D may occur in certain patients with lymphoma and suggest that this vitamin D metabolite may act as a humoral or systemic mediator of hypercalcemia. Proof that this is the case and identification of the source of 1,25- (OH)2D production will require further study.


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