IgG Heavy Chain Disease (γHCD) is a rare plasma cell disorder. Hypercalcemia related to plasma cell dyscrasias is related to non-PTHrP related mechanisms. Here we describe the first case of a patient with γHCD and P...IgG Heavy Chain Disease (γHCD) is a rare plasma cell disorder. Hypercalcemia related to plasma cell dyscrasias is related to non-PTHrP related mechanisms. Here we describe the first case of a patient with γHCD and PTHrP related hypercalcemia. Methods: Patient case derived from chart review from 2011 to 2015. Literature review performed searching PubMed 1968-current. Results: The patient was diagnosed with hypercalcemia with elevated PTHrP and exclusion of other etiologies of hypercalcemia. She was diagnosed with (γHCD) by M-spike 0.64 g/dL, IFE showing a broad band of IgG heavy chain, without associated light chains and severe depression of the non-mono-clonal IgG. Serum immunoglobulins demonstrated elevated IgG (2110 mg/dL), normal IgA (46 mg/dL) and decreased IgM (<21 mg/dL). Bone marrow biopsy showed 5% PCs, non-clonal by kappa/lambda, but exclusive for IgG by IHC, without any staining for IgA or IgM. The patient was started on therapy with improved hypercalcemia and PTHrP levels. Conclusions: This is the first reported case of γHCD presenting with PTHrP related hypercalcemia. Given that skeletal involvement is uncommon in γHCD, hypercalcemia secondary to γHCD may at times be a PTHrP driven phenomenon and we recommend that this test be ordered in such cases.展开更多
目的研究不同频度给予甲状旁腺激素相关肽(PTH rP 1-34)对去卵巢大鼠腰椎和股骨骨密度(BM D)及生物力学性能的影响。方法将70只大鼠分为7组,即假手术对照组(Sham组)、去卵巢对照组(OVX组)、苯甲酸雌二醇治疗组(E组)、PTH rP 1-34治疗组...目的研究不同频度给予甲状旁腺激素相关肽(PTH rP 1-34)对去卵巢大鼠腰椎和股骨骨密度(BM D)及生物力学性能的影响。方法将70只大鼠分为7组,即假手术对照组(Sham组)、去卵巢对照组(OVX组)、苯甲酸雌二醇治疗组(E组)、PTH rP 1-34治疗组(包括P 1D组、P 2D组、P 3D组、P 1W组)。去卵巢4周后,后四组均给予PTH rP 1-34 40μg/kg,分别按1次/d、1次/2d、1次/3d、1次/周皮下注射。治疗12周后处死大鼠,分离股骨、腰椎并测量其BM D,股骨做三点弯曲试验,第五腰椎做压缩试验。结果卵巢摘除术后,OVX组BM D较Sham组明显降低,表明大鼠骨质疏松模型建模成功。P 1D组和P 2D组股骨及腰椎BM D、最大载荷和弹性模量显著高于OVX组(P<0.05),与Sham组无统计学差异。结论PTH rP 1-34 40μg/kg剂量,1次/d或1次/2d皮下注射,可以提高去卵巢大鼠的BM D,改善其生物力学特性,有效地防治骨质疏松。展开更多
Here we report a patient diagnosed with small cell lung cancer after first presenting with parathyroid hormonerelated peptide-induced hypercalcemic pancreatitis and developed walled-off necrosis that resulted in disru...Here we report a patient diagnosed with small cell lung cancer after first presenting with parathyroid hormonerelated peptide-induced hypercalcemic pancreatitis and developed walled-off necrosis that resulted in disruption of the main pancreatic duct.Disconnected duct syndrome (DDS) is a rare syndrome that occurs when the main pancreatic duct exocrine flow is disrupted resulting in leakage of pancreatic enzymes and further inflammatory sequela.To date,no prior reports have described DDS occurring with paraneoplastic reactions.Diagnostic imaging techniques and therapeutic interventions are reviewed to provide insight into current approaches to DDS.展开更多
文摘IgG Heavy Chain Disease (γHCD) is a rare plasma cell disorder. Hypercalcemia related to plasma cell dyscrasias is related to non-PTHrP related mechanisms. Here we describe the first case of a patient with γHCD and PTHrP related hypercalcemia. Methods: Patient case derived from chart review from 2011 to 2015. Literature review performed searching PubMed 1968-current. Results: The patient was diagnosed with hypercalcemia with elevated PTHrP and exclusion of other etiologies of hypercalcemia. She was diagnosed with (γHCD) by M-spike 0.64 g/dL, IFE showing a broad band of IgG heavy chain, without associated light chains and severe depression of the non-mono-clonal IgG. Serum immunoglobulins demonstrated elevated IgG (2110 mg/dL), normal IgA (46 mg/dL) and decreased IgM (<21 mg/dL). Bone marrow biopsy showed 5% PCs, non-clonal by kappa/lambda, but exclusive for IgG by IHC, without any staining for IgA or IgM. The patient was started on therapy with improved hypercalcemia and PTHrP levels. Conclusions: This is the first reported case of γHCD presenting with PTHrP related hypercalcemia. Given that skeletal involvement is uncommon in γHCD, hypercalcemia secondary to γHCD may at times be a PTHrP driven phenomenon and we recommend that this test be ordered in such cases.
文摘Here we report a patient diagnosed with small cell lung cancer after first presenting with parathyroid hormonerelated peptide-induced hypercalcemic pancreatitis and developed walled-off necrosis that resulted in disruption of the main pancreatic duct.Disconnected duct syndrome (DDS) is a rare syndrome that occurs when the main pancreatic duct exocrine flow is disrupted resulting in leakage of pancreatic enzymes and further inflammatory sequela.To date,no prior reports have described DDS occurring with paraneoplastic reactions.Diagnostic imaging techniques and therapeutic interventions are reviewed to provide insight into current approaches to DDS.
