Lymphoma, Hypercalcemia, and the Sunshine Vitamin
1994; American College of Physicians; Volume: 121; Issue: 9 Linguagem: Inglês
10.7326/0003-4819-121-9-199411010-00012
ISSN1539-3704
Autores Tópico(s)Erythrocyte Function and Pathophysiology
ResumoEditorials1 November 1994Lymphoma, Hypercalcemia, and the Sunshine VitaminMalcolm Cox, MD and John G. Haddad, MDMalcolm Cox, MDVeterans Affairs Medical Center; Philadelphia, PA 19104Hospital of the University of Pennsylvania; Philadelphia, PA 19104 and John G. Haddad, MDVeterans Affairs Medical Center; Philadelphia, PA 19104Hospital of the University of Pennsylvania; Philadelphia, PA 19104Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-9-199411010-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Under normal circumstances, parathyroid hormone and 1 α,25-dihydroxycholecalciferol (calcitriol) jointly defend the plasma calcium concentration. Parathyroid hormone increases renal distal tubular calcium reabsorption and mobilizes calcium from bone. Calcitriol, the active product of vitamin D metabolism, enhances gastrointestinal calcium absorption and also mobilizes calcium from bone. The roles of parathyroid hormone and calcitriol in calcium homeostasis are intimately interrelated. Parathyroid hormone is the primary trophic stimulator of renal 1 α-hydroxylase, the enzyme that converts 25-hydroxycholecalciferol into calcitriol. Calcitriol, in turn, inhibits parathyroid hormone secretion by at least two different mechanisms: direct repression of the preproparathyroid hormone gene and inhibition of ...References1. Moseley JM, Kubota M, Diefenbach-Jagger H, Wettenhall RE, Kemp BE, Suva LJ, et al. Parathyroid hormone-related protein purified from a human lung cancer cell line. Proc Natl Acad Sci U S A. 1987; 84:5048-52. Google Scholar2. Burtis WJ, Wu T, Bunch C, Wysolmerski JJ, Insogna K, Weir EC, et al. Identification of a novel 17,000 dalton parathyroid hormone-like adenylate cyclase-stimulating protein from a tumor associated with humoral hypercalcemia of malignancy. J Biol Chem. 1987; 262:7151-6. Google Scholar3. Suva LJ, Winslow GA, Wettenhall RE, Hammonds RG, Moseley JM, Diefenbach-Jagger H, et al. A parathyroid hormone-related protein implicated in malignant hypercalcemia: cloning and expression. Science. 1987; 237:893-6. Google Scholar4. Mangin M, Webb AC, Dreyer BE, Posillico JT, Ikeda K, Weir EC, et al. Identification of a cDNA encoding a parathyroid hormone-like peptide from a human tumor associated with humoral hypercalcemia of malignancy. Proc Natl Acad Sci U S A. 1988; 85:597-601. Google Scholar5. Juppner H, Abou-Samra AB, Freeman M, Kong XF, Schipani E, Richards J, et al. A G-protein-linked receptor for parathyroid hormone and parathyroid hormone-related peptide. Science. 1991; 254:1024-6. Google Scholar6. Budayr AA, Nissenson RA, Klein RF, Pun KK, Clark OH, Diep D, et al. Increased serum levels of a parathyroid hormone-like protein in malignancy-associated hypercalcemia. Ann Intern Med. 1989; 111:807-12. Google Scholar7. Burtis WJ, Brady TG, Orloff JJ, Ersbak JB, Warrell RP Jr, Olson BR, et al. Immunochemical characterization of circulating parathyroid hormone-related protein in patients with humoral hypercalcemia of cancer. N Engl J Med. 1990; 322:1106-12. Google Scholar8. Kao PC, Klee GG, Taylor RL, Heath H 3d. Parathyroid hormone-related peptide in plasma of patients with hypercalcemia and malignant lesions. Mayo Clinic Proc. 1990; 65:1399-407. Google Scholar9. Ratcliffe WA, Hutchesson AC, Bundred NJ, Ratcliffe JG. Role of assays for parathyroid-hormone-related protein in investigation of hypercalcaemia. Lancet. 1992; 339:164-7. Google Scholar10. Mundy GR, Yates AJ. Recent advances in pathophysiology and treatment of hypercalcemia of malignancy. Am J Kidney Dis. 1989; 14:2-12. Google Scholar11. Stewart AF, Horst R, Deftos LJ, Cadman EC, Lang R, Broadus AE. Biochemical evaluation of patients with cancer-associated hypercalcemia: evidence for humoral and nonhumoral groups. N Engl J Med. 1980; 303:1377-83. Google Scholar12. Horiuchi N, Caulfield MP, Fisher JE, Goldman ME, McKee RL, Reagan JE, et al. Similaritry of synthetic peptide from human tumor to parathyroid hormone in vivo and in vitro. Science. 1987; 238:1566-8. Google Scholar13. Walker AT, Stewart AF, Korn EA, Shiratori T, Mitnick MA, Carpenter TO. Effect of parathyroid hormone-like peptides on 25-hydroxyvitamin D-1 α-hydroxylase activity in rodents. Am J Physiol. 1990; 258:E297-303. Google Scholar14. Rosol TJ, Nagode LA, Couto CG, Hammer AS, Chew DJ, Peterson JL, et al. Parathyroid hormone (PTH)-related protein, PTH, and 1,25-dihydroxyvitamin D in dogs with cancer-associated hypercalcemia. Endocrinology. 1992; 131:1157-64. Google Scholar15. Ralston SH, Cowan RA, Robertson AG, Gardner MD, Boyle IT. Circulating vitamin D metabolites and hypercalcaemia of malignancy. Acta Endocrinol (Copenh). 1984; 106:556-63. Google Scholar16. Fukumoto S, Matsumoto T, Yamoto H, Kawashima H, Ueyama Y, Tamaoki N, et al. Suppression of serum 1,25-dihydroxyvitamin D in humoral hypercalcemia of malignancy is caused by elaboration of a factor that inhibits renal 1,25-dihydroxyvitamin D3 production. Endocrinology. 1989; 124:2057-62. Google Scholar17. Schilling T, Pecherstorfer M, Blind E, Leidig G, Ziegler R, Raue F. Parathyroid hormone-related protein (PTHrP) does not regulate 1,25-dihydroxyvitamin D serum levels in hypercalcemia of malignancy. J Clin Endocrinol Metab. 1993; 76:801-3. Google Scholar18. Reichel H, Koeffler HP, Norman AW. The role of the vitamin D endocrine system in health and disease. N Engl J Med. 1989; 320:980-91. Google Scholar19. Dusso A, Brown A, Slatopolsky E. Extrarenal production of calcitriol. Semin Nephrol. 1994; 14:144-55. Google Scholar20. Manolagas SC, Yu XP, Girasole G, Bellido T. Vitamin D and the hematolymphopoetic tissue: a 1994 update. Semin Nephrol. 1994; 14:129-43. Google Scholar21. Reichel H, Koeffler HP, Barbers R, Norman AW. Regulation of 1,25-dihydroxyvitamin D3 production by cultured alveolar macrophages from normal human donors and from patients with pulmonary sarcoidosis. J Clin Endocrinol Metab. 1987; 65:1201-9. Google Scholar22. Adams JS, Gacad MA. Characterization of 1 α-hydroxylation of vitamin D3 sterols by cultured alveolar macrophages from patients with sarcoidosis. J Exp Med. 1985; 161:755-65. Google Scholar23. Seymour JF, Gagel RF. Calcitriol: the major humoral mediator of hypercalcemia in Hodgkin's disease and non-Hodgkin's lymphomas. Blood. 1993; 82:1383-94. Google Scholar24. Seymour JF, Gagel RF, Hagemeister FB, Dimopoulos MA, Cabanillas F. Calcitriol production in hypercalcemic and normocalcemic patients with non-Hodgkin lymphoma. Ann Intern Med. 1994; 121:633-640. Google Scholar25. Lawson-Matthew P, Clayton J, Guilland-Cumming D, Yates A, Preston E, Greaves M, et al. Vitamin D metabolism in myeloma. Br J Haematol. 1989; 73:57-60. Google Scholar26. Garrett IR, Durie BG, Nedwin GE, Gillespie A, Bringman T, Sabatini M, et al. Production of lymphotoxin, a bone resorbing cytokine, by cultured human myeloma cells. N Engl J Med. 1987; 317:526-32. Google Scholar27. Walters MR. Newly identified actions of the vitamin D endocrine system. Endocr Rev. 1992; 13:719-64. Google Scholar28. Holick MF. Vitamin D and the kidney (Clinical conference). Kidney Int. 1987; 32:912-29. Google Scholar29. DeLuca HF, Krisinger J, Darwish H. The vitamin D system: 1990. Kidney Int. 1990; 38(Suppl 29):S2-8. Google Scholar30. Bikle DD, Siiteri PK, Ryzen E, Haddad JG. Serum protein binding of 1,25-dihydroxyvitamin D: A reevaluation by direct measurement of free metabolite levels. J Clin Endocrinol Metab. 1985; 61:969-75. Google Scholar31. Seeman E, Kumar R, Hunder GG, Scott M, Heath H 3d, Riggs BL. Production, degradation, and circulating levels of 1,25-dihydroxyvitamin D in health and in chronic glucocorticoid excess. J Clin Invest. 1980; 66:664-6. Google Scholar32. Mudde AH, van den Berg H, Boshuis PG, Breedveld PC, Markuse HM, Kluin PM, et al. Ectopic production of 1,25-dihydroxyvitamin D by B-cell lymphoma as a cause of hypercalcemia. Cancer. 1987; 59:1543-6. Google Scholar33. Fetchick DA, Bertolini DR, Sarin PS, Weintraub ST, Mundy GR, Dunn JF. Production of 1,25-dihydroxyvitamin D3 by human T cell lymphotrophic virus-1-transformed lymphocytes. J Clin Invest. 1986; 78:592-6. Google Scholar34. Reichel H, Koeffler HP, Norman AW. 25-hydroxyvitamin D3 metabolism by human T-lymphotrophic virus-transformed lymphocytes. J Clin Endocrinol Metab. 1987; 65:519-26. Google Scholar35. Dodwell DJ, Abbas SK, Morton AR, Howell A. Parathyroid hormone-related protein[50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69] and response to pamidronate therapy for tumour-induced hypercalcaemia. Eur J Cancer. 1991; 12:1629-33. Google Scholar36. Wada S, Kitamura H, Matsuura Y, Katayama Y, Ohkawa H, Kugai N, et al. Parathyroid hormone-related protein as a cause of hypercalcemia in a B-cell type malignant lymphoma. Intern Med. 1992; 31:968-72. Google Scholar37. Dodd RC, Winkler CF, Williams ME, Bunn PA, Gray TK. Calcitriol levels in hypercalcemic patients with adult T-cell lymphoma. Arch Intern Med. 1986; 146:1971-2. Google Scholar38. Fukumoto S, Matsumoto T, Ikeda K, Yamashita T, Watanabe T, Yamaguchi K, et al. Clinical evaluation of calcium metabolism in adult T-cell leukemia/lymphoma. Arch Intern Med. 1988; 148:921-5. Google Scholar39. Motokura T, Fukumoto S, Matsumoto T, Takahashi S, Fujita A, Yamashita T, et al. Parathyroid hormone-related protein in adult T-cell leukemia-lymphoma. Ann Intern Med. 1989; 111:484-8. Google Scholar40. Senba M, Kawai K. Hypercalcemia and production of parathyroid hormone-like protein in adult T-cell leukemia-lymphoma (Letter). Eur J Haematol. 1992; 48:278-9. Google Scholar41. Breslau NA, McGuire JL, Zerwekh JE, Frenkel EP, Pak CY. Hypercalcemia associated with increased serum calcitriol levels in three patients with lymphoma. Ann Intern Med. 1984; 100:1-7. Google Scholar42. Johnston SR, Hammond PJ. Elevated serum parathyroid hormone related protein and 1,25-dihydroxycholecalciferol in hypercalcemia associated with adult T-cell leukemia-lymphoma. Postgrad Med J. 1992; 68:753-5. Google Scholar43. Reichel H, Koeffler HP, Norman AW. Synthesis in vitro of 1,25-dihydroxyvitamin D3 and 24,25-dihydroxyvitamin D3 by interferon-γ-stimulated normal human bone marrow and alveolar macrophages. J Biol Chem. 1987; 262:10931-7. Google Scholar44. Krakauer T, Oppenheim JJ. IL-1 and tumor necrosis factor-α each up-regulate both the expression of IFN-γ receptors and enhance IFN-γ-induced HLA-DR expression on human monocytes and a human monocytic cell line (THP-1). J Immunol. 1993; 150:1205-11. Google Scholar Author, Article, and Disclosure InformationAuthors: Malcolm Cox, MD; John G. Haddad, MDAffiliations: Veterans Affairs Medical Center; Philadelphia, PA 19104Hospital of the University of Pennsylvania; Philadelphia, PA 19104Corresponding Author: Malcolm Cox, MD, Medical Service RF 111, Veterans Affairs Medical Center, University and Woodland Avenues, Philadelphia, PA 19104. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCalcitriol Production in Hypercalcemic and Normocalcemic Patients with Non-Hodgkin Lymphoma John F. Seymour , Robert F. Gagel , Frederick B. Hagemeister , Meletios A. Dimopoulos , and Fernando Cabanillas Metrics Cited byHypercalcemia Due to Vitamin D ToxicityHHypercalcemia Due to Vitamin D ToxicityHypercalcemia and huge splenomegaly presenting in an elderly patient with B-cell non-Hodgkin's lymphoma: a case reportNOD/SCID mouse model of canine T-cell lymphoma with humoral hypercalcaemia of malignancy: cytokine gene expression profiling and in vivo bioluminescent imagingHypercalcemia Due to Vitamin D ToxicityMacronutrientsPathophysiology of Calcium, Phosphate, and Magnesium AbsorptionSymptomatic hypercalcemia in a diabetic patient undergoing continuous ambulatory peritoneal dialysis: Value of bone biopsy in the diagnosis and management 1 November 1994Volume 121, Issue 9Page: 709-712KeywordsCalcitriolCalciumHodgkin lymphomaHypercalcemiaLymphomaMacrophagesParathyroidParathyroid hormoneProteinsVitamin D ePublished: 15 August 2000 Issue Published: 1 November 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Referência(s)