American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: http://www.sciepub.com/journal/ajmcr Editor-in-chief: Samy, I. McFarlane
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American Journal of Medical Case Reports. 2014, 2(2), 35-38
DOI: 10.12691/ajmcr-2-2-2
Open AccessCase Report

Non-Hodgkin's Lymphoma Complicated with Marked Hypercalcemia Caused by Parathyroid Hormone Related Protein, Presenting with Adams-Stokes Attack

Motoharu Shibusawa1, , Sayuri Motomura1, Hiroko Hidai1, Hidetaka Ina2, Satoshi Murasaki2 and Hisashi Tsutsumi1

1Department of Hematology, Tokyo Metropolitan Health and Medical Treatment Corporation, Tama-Hokubu Medical Center, Higasimurayamasi, Tokyo, Japan

2Department of Cardiovascular Medicine, Tokyo Metropolitan Health and Medical Treatment Corporation, Tama-Hokubu Medical Center, Higasimurayamasi, Tokyo, Japan

Pub. Date: February 25, 2014

Cite this paper:
Motoharu Shibusawa, Sayuri Motomura, Hiroko Hidai, Hidetaka Ina, Satoshi Murasaki and Hisashi Tsutsumi. Non-Hodgkin's Lymphoma Complicated with Marked Hypercalcemia Caused by Parathyroid Hormone Related Protein, Presenting with Adams-Stokes Attack. American Journal of Medical Case Reports. 2014; 2(2):35-38. doi: 10.12691/ajmcr-2-2-2

Abstract

A rare case of non-Hodgkin's lymphoma (NHL) complicated with marked hypercalcemia caused by parathyroid hormone related protein (PTHrP) and presenting with Adams-Stokes attack is reported. A 72-year-old woman was involved in a traffic accident, and was transferred to our hospital. Blood examination revealed marked hypercalcemia (5.3 mmol/l (21.3 mg/dl)). A diagnosis of NHL (B-cell lymphoma, clinical stage IVA) was made by the results of the bone marrow biopsy, CT features showing multiple masses, and the gallium scintigraphy showing strong accumulation. Because of high blood level of PTHrP, hypercalcemia was considered to be due to PTHrP as a mediator acting on calcium metabolism. Hypercalcemia complicated with malignancy has a risk resulting in a fatal outcome. In the cases of malignant lymphoma complicated with hypercalcemia, we should pay attention to PTHrP as a mediator.

Keywords:
lymphoma hypercalcemia parathyroid hormone related protein

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