TY - JOUR
T1 - Expression of parathyroid hormone-related protein (PTHrP) in multiple myeloma
AU - Kitazawa, Riko
AU - Kitazawa, Sohei
AU - Kajimoto, Kazuyoshi
AU - Sowa, Hideaki
AU - Sugimoto, Toshitsugu
AU - Matsui, Tosimitsu
AU - Chihara, Kazuo
AU - Maeda, Sakan
PY - 2002
Y1 - 2002
N2 - Multiple myeloma is a plasma cell neoplasia often associated with multiple skeletal lesions and hypercalcemia. Several cytokines, including interleukin (IL)-1, IL-6 and tumor necrosis factor-β (TNF-β), derived from myeloma cells are thought to accelerate osteoclastic bone resorption and cause hypercalcemia through a paracrine mechanism. We report on a case of a 69-year-old man with multiple myeloma associated with hypercalcemia and advanced osteolytic lesions. After bisphosphonate treatment and MP (melphalan and prednisolone) therapy, the patient's serum calcium level was successfully but transiently recovered to the normal range. Biochemical analysis showed a remarkable increase in serum parathyroid hormone-related protein (PTHrP; 3.7 pmol/L) and IL-6 (22.0 pg/mL). On the other hand, parathyroid hormone and 1α,25(OH)2 vitamin D3 were suppressed. By immunohistochemistry and in situ hybridization on aspiration-biopsied bone marrow clot sections, PTHrP mRNA and protein were detected in the cytoplasm of myeloma cells. The rate of PTHrP-positive myeloma cells was estimated to be at least one-third. Since PTHrP can, as an endocrine factor, systemically act on bone and kidney, hypercalcemia in this case might have been caused through both local osteolytic hypercalcemia and humoral hypercalcemia of malignancy mechanisms.
AB - Multiple myeloma is a plasma cell neoplasia often associated with multiple skeletal lesions and hypercalcemia. Several cytokines, including interleukin (IL)-1, IL-6 and tumor necrosis factor-β (TNF-β), derived from myeloma cells are thought to accelerate osteoclastic bone resorption and cause hypercalcemia through a paracrine mechanism. We report on a case of a 69-year-old man with multiple myeloma associated with hypercalcemia and advanced osteolytic lesions. After bisphosphonate treatment and MP (melphalan and prednisolone) therapy, the patient's serum calcium level was successfully but transiently recovered to the normal range. Biochemical analysis showed a remarkable increase in serum parathyroid hormone-related protein (PTHrP; 3.7 pmol/L) and IL-6 (22.0 pg/mL). On the other hand, parathyroid hormone and 1α,25(OH)2 vitamin D3 were suppressed. By immunohistochemistry and in situ hybridization on aspiration-biopsied bone marrow clot sections, PTHrP mRNA and protein were detected in the cytoplasm of myeloma cells. The rate of PTHrP-positive myeloma cells was estimated to be at least one-third. Since PTHrP can, as an endocrine factor, systemically act on bone and kidney, hypercalcemia in this case might have been caused through both local osteolytic hypercalcemia and humoral hypercalcemia of malignancy mechanisms.
KW - Hypercalcemia
KW - Immunohistochemistry
KW - In situ hybridization
KW - Multiple myeloma
KW - Parathyroid hormone-related protein (PTHrP)
UR - http://www.scopus.com/inward/record.url?scp=0036222381&partnerID=8YFLogxK
U2 - 10.1046/j.1440-1827.2002.01314.x
DO - 10.1046/j.1440-1827.2002.01314.x
M3 - Article
C2 - 11940209
AN - SCOPUS:0036222381
SN - 1320-5463
VL - 52
SP - 63
EP - 68
JO - Pathology International
JF - Pathology International
IS - 1
ER -