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Treatment by Hepatic Enzyme Induction

Maximo Maislos, MD; Richard Sobel, MD; Shraga Shany, PhD

Arch Intern Med. 1985;145(3):565-567.

Abstract

• A 42-year-old woman, with a previously resected jejunal leiomyoblastoma, was first seen with liver metastases 3 years after the tumor resection. Intractable malignant hypercalcemia appeared eight months later, together with renal insufficiency. No osteolytic lesions were detected. Levels of parathyroid hormone, cyclic adenosine monophosphate, and 1,25-dihydroxycholecalciferol (1,25[OH]₂D) were not useful in distinguishing between the hypercalcemia of malignancy and concurrent hyperparathyroidism. Despite renal insufficiency, hypercalcemia, and subtotal parathyroidectomy, the 1,25(OH)₂D levels remained elevated, consistent with the speculation that a tumor product stimulated 1--hydroxylation of 25-hydroxycholecalciferol. Phenytoin and phenobarbital (enzyme induction therapy), in combination with phosphorus and glucocorticoids, appeared to be useful in controlling the hypercalcemia.

(Arch Intern Med 1985;145:565-567)

Author Affiliations

Footnotes

Reprint requests to Department of Medicine, Soroka Medical Center, PO Box 151, Beer-Sheva 84-101, Israel (Dr Sobel).

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