ESPE Abstracts (2018) 89 P-P3-064

Hypercalcemia Associated with Increased Parathyroid Hormone-related Protein (PTHrP) in a Patient with Medulloblastoma Successfully Treated with Pamidronate

Seok Jin Kang & Heung Sik Kim

Keimyung University School of Medicine Department of Pediatrics, Daegu, Republic of Korea

We report a patient with medulloblastoma showing severe hypercalcemia and a raised PTHrP serum level. He was a 19-year-old with a history of recurrent medulloblastoma. He developed constipation, lethargy and altered mentality for 3 weeks. There was no family history of hypercalcemia. Laboratory test revealed hypercalcemia of 18.2 mg/dL. PTHrP increased to 10.7 pmol/L (normal range: <1.1 pmol/L), whereas serum level of intact parathyroid hormone was suppressed to 5 pg/mL (normal range: 15–65 pg/mL). Intoxication of 25-hydroxy-vitamin D3 and 1,25-dihydroxy vitamin D3 was also excluded. After the diagnosis of humoral hypercalcemia was made, single dose of intravenous pamidronate (1 mg/kg) was injected to patient with massive hydration. After 3 days, level of serum calcium was normalized. After 7 days hypocalcemia which was one of the complications of bisphosphnates developed. Although long-term efficacy and safety data are insufficient, bisphosphonates can be effective treatment for humoral hypercalcemia associated with malignancy.

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