Hypocalcemia with osteoblastic metastases in a patient with prostate carcinoma. A cause of secondary hyperparathyroidism

Robert Christian Smallridge, H. Linton Wray, Marcus Schaaf

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

A 68 year old man with prostatic carcinoma and extensive painful osteoblastic metastases was discovered to have hypocalcemia (serum calcium 7.1 mg/dl) without evidence of hypoalbuminemia, renal failure or malabsorption. Baseline studies revealed hypocalciuria (24 hour urine calcium <5 mg/day), normal serum phosphate (3.4 mg/dl), low tubular reabsorption of phosphate (68 percent), undetectable serum calcitonin, normal serum 25-hydroxyvitamin D, slightly elevated serum parathyroid hormone level and increased urinary cyclic AMP (8.87 μmol/g creatinine). These studies were compatible with secondary hyperparathyroidism. The intravenous administration of parathyroid extract produced no further change in urinary phosphate but a 25-fold increase in nephrogenous cyclic AMP. Three days administration of intramuscular parathyroid extract slowly and temporarily restored serum calcium to normal levels while increasing urinary cyclic AMP and phosphate. Chemotherapy with cyclophosphamide and 5-fluorouracil rendered the patient free of pain while reducing serum acid and alkaline phosphatase levels and restoring serum total and ionized calcium and urinary cyclic AMP excretion to normal.

Original languageEnglish (US)
Pages (from-to)184-188
Number of pages5
JournalThe American journal of medicine
Volume71
Issue number1
DOIs
StatePublished - 1981
Externally publishedYes

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Secondary Hyperparathyroidism
Hypocalcemia
Prostate
Neoplasm Metastasis
Carcinoma
Serum
Cyclic AMP
Phosphates
Calcium
Hypoalbuminemia
Calcitonin
Acid Phosphatase
Parathyroid Hormone
Fluorouracil
Intravenous Administration
Cyclophosphamide
Renal Insufficiency
Alkaline Phosphatase
Creatinine
Urine

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Hypocalcemia with osteoblastic metastases in a patient with prostate carcinoma. A cause of secondary hyperparathyroidism. / Smallridge, Robert Christian; Wray, H. Linton; Schaaf, Marcus.

In: The American journal of medicine, Vol. 71, No. 1, 1981, p. 184-188.

Research output: Contribution to journalArticle

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