Severe Refractory Calcitriol-Mediated Hypercalcemia in Diffuse Large B-Cell Lymphoma Treated With Hemodialysis.

Hypercalcemia of malignancy is a recognized complication of diffuse large B-cell lymphoma (DLBCL) and is associated with decreased survival time and more advanced disease. We present a case of DLBCL complicated by severe refractory calcitriol-mediated hypercalcemia and renal failure that was unresponsive to conventional treatments. Treatment with glucocorticoids and concurrent antiresorptive therapy was also ineffective. Ultimately, hemodialysis was necessary to treat the patient's hypercalcemia and tenuous volume status. This case demonstrates that calcitriol-mediated hypercalcemia of malignancy in DLBCL may be unresponsive to standard hypercalcemia interventions, and it supports the utility of hemodialysis as a method of treating hypercalcemia, especially in patients with renal impairment.