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Clinical Evaluation of Calcium Metabolism in Adult T-Cell Leukemia/Lymphoma
Seiji Fukumoto, MD;
Toshio Matsumoto, MD;
Kyoji Ikeda, MD;
Takayuki Yamashita, MD;
Toshiki Watanabe, MD;
Kazunari Yamaguchi, MD;
Tetsuyuki Kiyokawa, MD;
Kiyoshi Takatsuki, MD;
Naohiko Shibuya;
Etsuro Ogata, MD
Arch Intern Med. 1988;148(4):921-925.
Abstract
• To clarify the mechanism of development of hypercalcemia in adult T-cell leukemia/lymphoma (ATLL), ten patients with a serum creatlnlne level less than 177 µmol/L (2 mg/dL) were examined. Although hypercalcemia was seen in only four (40%) of these patients, four of six normocalcemic patients showed hypercalciuria (>5 mmol/d [>200 mg/24 h]). All hypercalcemic patients exhibited high nephrogenous cyclic adenosine monophosphate (NcAMP) levels in the face of low-normal immunoreactive parathyroid hormone and reduced serum 1,25-dihydroxyvitamin D [1,25(OH)2D] concentration. Half of the hypercalciuric patients with normocalcemia also showed high NcAMP and reduced serum 1,25(OH)2D levels. Furthermore, the changes in NcAMP and serum 1,25(OH)2D concentration closely paralleled the development of hypercalcemia and hypercalciuria in two patients. These results are reminiscent of the syndrome of humoral hypercalcemia of malignancy and suggest that derangements in calcium metabolism develop by a similar mechanism in patients with ATLL. The present data also indicate the importance of the measurement of urinary calcium excretion for early detection and prevention of fatal hypercalcemia in patients with ATLL.
(Arch Intern Med 1988;148:921-925)
Author Affiliations
From the Fourth Department of Internal Medicine, University of Tokyo School of Medicine, Bunkyo-ku (Drs Fukumoto, Matsumoto, Ikeda, Yamashita, Watanabe, and Ogata); the Second Department of Internal Medicine, University of Kumamoto (Japan) School of Medicine (Drs Yamaguchi, Kiyokawa, and Takatsuki); and the Mitsubishi Yuka Medical Sciences, Nerima-ku, Tokyo (Mr Shibuya).
Footnotes
Accepted for publication Nov 3, 1987.
Read in part before the Ninth Annual Meeting of the American Society for Bone and Mineral Research, Indianapolis, June 9, 1987.
Reprint requests to Fourth Department of Internal Medicine, University of Tokyo School of Medicine, 3-28-6 Mejirodai, Bunkyo-ku, Tokyo 112, Japan (Dr Matsumoto).
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