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Association With Elevated 1,25-Dihydroxycholecalciferol Levels and Subperiosteal Bone Resorption

Gary P. Zaloga, MD; Charles Eil, MD, PhD; Clinton A. Medbery, MD

Arch Intern Med. 1985;145(1):155-157.

Abstract
• A 58-year-old man was initially seen with fatigue and weight loss. Laboratory examination detected hypercalcemia, elevated 1,25-dihydroxycholecalciferol levels, low parathyroid hormone (PTH) concentrations, and subperiosteal bone resorption. The patient underwent subtotal parathyroidectomy for presumed hyperparathyroidism, but serum calcium and 1,25-dihydroxycholecalciferol levels remained elevated following surgery. Search for another cause of the hypercalcemia disclosed enlarged para-aortic lymph nodes, biopsy specimens of which demonstrated Hodgkin's disease. After treatment of the patient with two cycles of chemotherapy with mechlorethamine hydrochloride, vincristine sulfate, procarbazine hydrochloride, and prednisone, serum calcium, 1,25-dihydroxycholecalciferol, and PTH levels normalized. We speculate that the humoral hypercalcemia in this patient resulted from tumor production of 1,25-dihydroxycholecalciferol.

(Arch Intern Med 1985;145:155-157)

Author Affiliations
From the Departments of Medicine, Endocrinology and Metabolism Branch, Naval Hospital Bethesda, the Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Md (Drs Zaloga and Eil); and the Department of Medicine, the Naval Hospital, Charleston, SC (Dr Medbery).

Footnotes
Accepted for publication March 30, 1984.

The opinions expressed herein are those of the authors and are not to be construed as reflecting the views of the Navy Department, of the Naval Service at large, or of the Department of Defense.

Reprint requests to Naval Hospital, Bethesda, MD 20814 (Dr Zaloga).

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