Vitamin D Metabolite-Mediated Hypercalcemia in Wegener's Granulomatosis
Identifieur interne : 002856 ( Main/Exploration ); précédent : 002855; suivant : 002857Vitamin D Metabolite-Mediated Hypercalcemia in Wegener's Granulomatosis
Auteurs : Xavier Bosch [Espagne] ; Alfonso Lopez-Soto [Espagne] ; Antonio Morello [Espagne] ; Angel Olmo [Espagne] ; Alvaro Urbano-Marqlez [Espagne]Source :
- Mayo Clinic Proceedings [ 0025-6196 ] ; 1997.
English descriptors
- Teeft :
- Anca, Biochem pharmacol, Calcium metabolism, Camp cyclic adenosine monophosphate, Clin, Corticosteroid, Cyclophosphamide, Cyclophosphamide therapy, Direct correlation, Disease activity, Endogenous overproduction, Excessive synthesis, Facial palsy, Granulomatosis, Granulomatosis mayo clin proc, Granulomatous, Granulomatous diseases, Hearing loss, Hormonal perturbation, Hypercalcemia, Indirect action, Indirect immunofluorescence, Ipth, Leukocyte count, Lung involvement, Macrophage, Mayo, Mayo clin proc, Mayo clinic proceedings, Mayo clio proc, Nichols institute diagnostics, Normal range, Other granulomatous diseases, Prominent sign, Right side, Sarcoid granulomas, Sarcoid macrophage, Sarcoidosis, Serum concentrations, Serum level, Serum levels, Substantial decrease, Symptomatic hypercalcemia, Total serum calcium level, Urinary, Urinary calcium concentrations, Urinary calcium levels, Urinary excretion, Wegener granulomas.
Abstract
Hypercalcemia may occur during the course of various granuloma-forming diseases. Herein we describe a patient who had symptomatic hypercalcemia as a prominent sign of Wegener's granulomatosis. We observed a direct correlation between the serum levels of 1,25-dihydroxyvitamin D [l,25(OH)2D] and both the serum and the urinary calcium levels. Administration of prednisone and cyclophosphamide led to a substantial decrease in the levels of calcium and serum l,25(OH)2D, but the serum levels of 25-hydroxyvitamin D remained unchanged. Two months after admission of the patient, the levels of calcium and l,25(OH)2D increased; after we increased the dose of cyclophosphamide, these levels decreased (the dose of corticosteroids was not changed). We suggest that the excessive synthesis of l,25(OH)2D was inhibited by a direct or indirect action not only of prednisone but also of cyclophosphamide on the la-hydroxylation of 25-hydroxyvitamin D in the activated macrophage of Wegener granulomas. Furthermore, in view of this case and two other recently reported cases, we believe that Wegener's granulomatosis must be definitively added to the list of granulomatous diseases that are responsible for l,25(OH)2D-mediated hypercalcemia.
Url:
DOI: 10.4065/72.5.440
Affiliations:
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involvement</term><term>Macrophage</term><term>Mayo</term><term>Mayo clin proc</term><term>Mayo clinic proceedings</term><term>Mayo clio proc</term><term>Nichols institute diagnostics</term><term>Normal range</term><term>Other granulomatous diseases</term><term>Prominent sign</term><term>Right side</term><term>Sarcoid granulomas</term><term>Sarcoid macrophage</term><term>Sarcoidosis</term><term>Serum concentrations</term><term>Serum level</term><term>Serum levels</term><term>Substantial decrease</term><term>Symptomatic hypercalcemia</term><term>Total serum calcium level</term><term>Urinary</term><term>Urinary calcium concentrations</term><term>Urinary calcium levels</term><term>Urinary excretion</term><term>Wegener granulomas</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Hypercalcemia may occur during the course of various granuloma-forming diseases. Herein we describe a patient who had symptomatic hypercalcemia as a prominent sign of Wegener's granulomatosis. We observed a direct correlation between the serum levels of 1,25-dihydroxyvitamin D [l,25(OH)2D] and both the serum and the urinary calcium levels. Administration of prednisone and cyclophosphamide led to a substantial decrease in the levels of calcium and serum l,25(OH)2D, but the serum levels of 25-hydroxyvitamin D remained unchanged. Two months after admission of the patient, the levels of calcium and l,25(OH)2D increased; after we increased the dose of cyclophosphamide, these levels decreased (the dose of corticosteroids was not changed). We suggest that the excessive synthesis of l,25(OH)2D was inhibited by a direct or indirect action not only of prednisone but also of cyclophosphamide on the la-hydroxylation of 25-hydroxyvitamin D in the activated macrophage of Wegener granulomas. Furthermore, in view of this case and two other recently reported cases, we believe that Wegener's granulomatosis must be definitively added to the list of granulomatous diseases that are responsible for l,25(OH)2D-mediated hypercalcemia.</div></front></TEI><affiliations><list><country><li>Espagne</li></country><region><li>Catalogne</li></region><settlement><li>Barcelone</li></settlement></list><tree><country name="Espagne"><region name="Catalogne"><name sortKey="Bosch, Xavier" sort="Bosch, Xavier" uniqKey="Bosch X" first="Xavier" last="Bosch">Xavier Bosch</name></region><name sortKey="Lopez Soto, Alfonso" sort="Lopez Soto, Alfonso" uniqKey="Lopez Soto A" first="Alfonso" last="Lopez-Soto">Alfonso Lopez-Soto</name><name sortKey="Morello, Antonio" sort="Morello, Antonio" uniqKey="Morello A" first="Antonio" last="Morello">Antonio Morello</name><name sortKey="Olmo, Angel" sort="Olmo, Angel" uniqKey="Olmo A" first="Angel" last="Olmo">Angel Olmo</name><name sortKey="Urbano Marqlez, Alvaro" sort="Urbano Marqlez, Alvaro" uniqKey="Urbano Marqlez A" first="Alvaro" last="Urbano-Marqlez">Alvaro Urbano-Marqlez</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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