Hypercalcemia Syndrome

Hypercalcemia is a relatively common manifestation in cancer present in up to 40% of patients, depending on the type of tumor [3]. The cause of hypercalcemia is a cancer-produced substance which has some PTH activities. This protein has been termed PTH-related protein (PTH-RP), and is a 141-amino acid protein homologous with PTH in its amino terminus [6]. The

PTH-RP gene is located on the short arm of chromosome 12 and has been shown to be expressed at low levels in many normal tissues, such as lactating breast and keratinocytes [7] where it acts in paracrine fashion. Following malignant transformation there is an increased PTH-RP gene expression following production of large amounts of this protein. In this state, PTH-RP behaves as a hormone causing bone resorption and renal phosphate wasting, which is expressed by hypercalcemia and hypophosphatemia.

The mechanism involved in causing hypercalcemia in hematological malignancies is somewhat different. In multiple myeloma cytokines such as lymphotoxin and tumor necrosis factor, act locally on the osteoclasts adjacent to the myeloma cells. On the other hand, in T-cell lymphomas, increased production of 1,25 OH vitamin D is probably the causing factor involved in producing hypercalcemia.

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Responses

  • Nelma
    Is hypercalcemia an autoimmune?
    7 years ago
  • kirk
    What autoimmune diseases cause hypercalcemia?
    8 months ago

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