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Concomitant plasma cell myeloma and chronic myelomonocytic leukemia in elderly: diagnostic complexity, therapeutic challenges - case report and literature review.

INTRODUCTION AND IMPORTANCE: Chronic Myelomonocytic Leukemia (CMML) is a rare clonal hematopoietic disorder with overlapping features of mye … ings revealed marked leukocytosis (WBC 85 × 103/μl), monocytosis (30.1%), anemia, thrombocytopenia, hypercalcemia, and renal dysfunction. Imaging showed sclerotic bone lesions and bilateral hydronephrosis. Bone marrow biopsy revealed 20-25% CD138+ plasma cells alongside features of CMML, including myeloid hyperplasia and atypical megakaryocytes. Next-generation …

Normalized Serum Calcium and Maintained Tacrolimus Levels by Cinacalcet Use in Kidney Transplant Recipients.

BACKGROUND: Hypercalcemia with persistent hyperparathyroidism after kidney transplantation is an important risk of cardiovascular disease and allograft dysfunction in kidney transplant recipients (KTRs). Cinacalcet, a calcium-sensing receptor agonist, is commonly used in chronic hemodialysis recipients with secondary hyperparathyroidism; however, its effect and safety in kidney transplant recipients are not established. METHODS: A prospective cohort study was conducted in KTRs with persistent hyperparathyroidism (intact parathyroid hormone [iPTH] >65 pg/mL) for at least 1 year post-transplant…

The prognostic impact of 1q21 gain/amplification in newly diagnosed multiple myeloma: a retrospective study based on a single center in China.

1q21gain/amp is the most common in patients with multiple myeloma. However, there is limited research on the prognostic heterogeneity of 1q21+, and the prognostic of the 1q21 copy remains controversial. In this study, we primarily conducted a retrospective analysis of the prognostic significance of 1q21 gain/amp in 375 newly diagnosed multiple myeloma patients. 1q21 + was detected in 164 (43.7%) patients, including 103 (27.5%) with 3 copies and 61 (16.3%) with ≥ 4 copies. Patients with 1q21 + were more likely to be accompanied by anemia, hypercalcemia, t(4;14), and t(14;16). Compared with 1q21…

Множественная миелома в молодом возрасте из центра лечения рака третьей ступени в Индии.

Множественная миелома (ММ) является главным образом болезнью пожилых людей; данные о молодых пациентах ограничены. ≤ 40 Мы ретроспективно проанализировали вновь диагностированные пациенты MM в возрасте ≤ 40 годы между 2013 и 2021. РЕШЕНИЙ 1980 - пациентов, прошедших обследование; 110 (В тыс.5.5%) были ≤ 40 годы (средний возраст) 36). Гиперкальцемия, почечная дисфункция, анемия и повреждения костей (CRAB) 11.9%, 17.3%, 42.7%, и 92.6% пациентов соответственно. Более one- третий этап Международной системы уплотнения (МСУ), 20.8% HR цитогенетики и 21.6% :: заболевания легких цепочек (ЛЦД). Множест

Совпадение в аннотации оригинала
BackgroundMultiple myeloma (MM) is primarily a disease of the elderly; data on young patients are limited.AimTo evaluate the clinical charac … between 2013 and 2021.ResultsOf 1980 patients screened, 110 (5.5%) were ≤ 40 years (median age 36). Hypercalcemia, renal dysfunction, anemia, and bone lesions (CRAB) were seen in 11.9%, 17.3%, 42.7%, and 92.6% of patients, respectively. More than one-third had International Staging System (ISS) Stage III, 20.8% had HR cytogenetics and 21.6% had light chain dise …

Consensus-Based Recommendations for the Diagnosis, Treatment, and Monitoring of Hypoparathyroidism: Insights from the DACH Region.

Hypoparathyroidism (HypoPT) is a rare endocrine disorder characterized by low parathyroid hormone (PTH) levels, hypocalcemia, hyperphosphate … normal range, symptom control, and quality of life. Long-term objectives include avoiding hypo- and hypercalcemia phases and disease-related complications. Failure of calcium and active vitamin D therapy is defined by persistent symptoms, hospitalization, laboratory values outside of the normal range, or medication intolerance. Experts emphasized using HypoPT-s …

Serum PTH ≥ 40 pg/mL as a Marker of Bone Fragility and Vitamin D Deficiency in Periodontitis Patients: Biochemical, Densitometric and Genetic Evidence.

(1) Background: this study aimed to determine whether a serum parathyroid hormone (PTH) threshold of 40 pg/mL represents a clinically releva … identifies individuals at higher risk of VitD deficiency and skeletal fragility, even without overt hypercalcemia. Genetic factors, particularly ERα variants, may contribute to elevated PTH levels, suggesting value in integrating biochemical, densitometric, and genetic screening for early bone health risk stratification.

Paraneoplastic syndromes in ovarian cancer: Clinical manifestations, mechanisms and management challenges.

Paraneoplastic syndromes encompass an enigmatic spectrum of clinical manifestations precipitated by various malignancies but not attributabl … llar degeneration, anti-N-methyl-D-aspartate receptor encephalitis, and metabolic disturbances like hypercalcemia, Cushing's syndrome, and thromboembolic states. Despite significant advancements, the diverse clinical presentations of paraneoplastic syndromes continue to pose substantial diagnostic ambiguities, with challenges in surgical planning and operative …

Novel Variants and Clinical Heterogeneity in Pediatric Calcium Metabolism Disorders Identified Through High-Yield Tiered Genetic Testing in a Taiwanese Cohort.

Background and Objectives: Inherited disorders of calcium metabolism are rare pediatric conditions with diverse manifestations, including se … d by PTH resistance (n = 3), hyperparathyroidism (n = 1), calcipenic rickets (n = 1), and syndromic hypercalcemia (n = 1). Genetic diagnoses were established in 12 children and one parent, involving CASR, GNAS, PRKAR1A, CYP27B1, and KMT2D. Two novel variants were identified (CASR p.Val836Ile and GNAS c.719-30A>T). Phenotypic heterogeneity included incomplete pe …

Multiple Bone Cysts Caused by Hyperparathyroidism: A Case Report and Review of the Literature.

BACKGROUND: Brown tumor, a skeletal complication of severe hyperparathyroidism, comprises reparative granulation tissue and proliferating fi … e cystic lesions in the bilateral femurs, left proximal tibia, and ilium. Laboratory tests revealed hypercalcemia (albumin-corrected calcium level, 13.9 mg/dl), hypophosphatemia (phosphate level, 1.6 mg/dl), elevated level of alkaline phosphatase level (614 U/l), and markedly elevated parathyroid hormone (PTH) level (1,070 pg/ml; normal range=10-65 ng/l). 99mTc …

Isolated coagulopathy without classic CRAB symptoms as the initial manifestation of multiple myeloma: A case report.

BACKGROUND: Multiple myeloma patients usually present with CRAB symptoms (hypercalcemia, renal disease, anemia and bone diseases) as initial manifestations. Bleeding symptoms are less common, most of which result from thrombocytopenia or infiltration of plasmacytoma. Relatively, coagulopathy is not so common, especially isolated coagulopathy without CRAB manifestations, which is very rare. Herein, we report a 54-year old female who was hospitalized for intermittent and recurrent mild oral mucosal hemorrhage without other bleeding symptoms for almost one month or typical myeloma features. CASE…

Pott's disease (tuberculous spondylitis).

Pott's disease is a vertebral infection caused by Mycobacterium tuberculosis. Indolent nature and subacute course are associated with late d … ely:weight loss and pain during thoracic palpation. Annalistically: normocytic/normochromic anemia, hypercalcemia, hepatic cholestasis, C-reactive protein (CRP) 7.12 mg/dL. Chest X-ray and electrocardiogram without alterations. She was admitted in Internal Medicine service. Analytically: hypophosphatemia, parathyroid hormone elevated, CRP 6 mg/dL, Beta-2 microg …

Serum PTH reference values in an adult Brazilian population: implications for the diagnosis of hyperparathyroidism.

OBJECTIVE: To define serum parathyroid hormone (PTH) reference values in carefully selected subjects following the recommended pre-analytical guidelines. SUBJECTS AND METHODS: First, 676 adults who would be submitted to thyroidectomy were evaluated. Patients using interfering medications or with malabsorption syndrome, hypomagnesemia, hyper- or hypophosphatemia, hypo- or hypercalcemia, 25-hydroxyvitamin D < 30 ng/dL, estimated glomerular filtration rate < 60 mL/min/1.73 m2, urinary calcium/creatinine ratio ≥ 0.25, thyroid dysfunction, parathyroid adenoma detected during surgery were excluded.…

Factors associated with late recurrence after parathyroidectomy for primary hyperparathyroidism.

BACKGROUND: A recent study with unusually lengthy follow-up after surgery for primary hyperparathyroidism reported higher recurrence rates than previously appreciated. We sought to identify specific factors associated with late recurrence after seemingly curative parathyroidectomy. METHODS: Prospectively collected data were retrieved for patients who had surgical treatment of sporadic primary hyperparathyroidism with ≥ 3-year follow-up (3-17.6 years). Recurrence was defined by 6 months of eucalcemia with subsequent hypercalcemia and a high or unsuppressed parathyroid hormone. Recurrent patien…

[Trends in parathyroid hormone plasma concentration in critically ill patients: prospective observational study].

OBJECTIVE: Introduction: There is no data in the literature regarding trends in parathormone serum concentration assessment in critically ill patients. The aim: To assess the parathyroid hormone plasma concentrations and kinetics in critically ill patients admitted to the intensive care unit due to multiorgan failure. PATIENTS AND METHODS: Materials and methods: Thirty multiorgan failure (at least circulatory and respiratory failure) patients were included. Patients who met any of the following criteria were excluded: acute liver failure, end stage renal disease, hypercalcemia, parathyroid gl…

Efficacy and Safety of 90,000 IU versus 300,000 IU Single Dose Oral Vitamin D in Nutritional Rickets: A Randomized Controlled Trial.

AIM: To compare efficacy and safety of 90,000 IU versus 300,000 IU oral single dose vitamin D for treatment of nutritional rickets. STUDY D … 25(OH)D, ALP, and PTH were similar between the groups at baseline and follow up. Hypercalciuria and hypercalcemia were seen more often in group B as was hypervitaminosis D. There were no clinical adverse events. CONCLUSIONS: Single oral dose vitamin D3 90,000 IU is safe and effective in achieving healing of rickets.

Effectiveness and safety of a 6-month treatment with paricalcitol in patients on hemodialysis with secondary hyperparathyroidism.

INTRODUCTION: The mineral bone disorder, particularly secondary hyperparathyroidism, in chronic kidney disease (CKD) has a systemic impact a … 00 pg/mL), with a median time of 2 months from the beginning of treatment. All reported episodes of hypercalcemia (n = 2) and hyperphosphatemia (n = 34) were asymptomatic. No major therapy-related serious AEs were reported. CONCLUSION: Paricalcitol was safely administered and was associated with significant decreases in iPTH levels over the study period.

Cholecalciferol Additively Reduces Serum Parathyroid Hormone and Increases Vitamin D and Cathelicidin Levels in Paricalcitol-Treated Secondary Hyperparathyroid Hemodialysis Patients.

BACKGROUND: Active Vitamin D analogues are used clinically for prevention and treatment of secondary hyperparathyroidism (SHPT) in hemodialysis (HD) patients. Nutritional vitamin D supplementation is used for additional local parathyroid (PTH) suppression, with lower incidence of hypercalcemia and hyperphosphatemia. This study evaluates the possible beneficial effects of combined vitamin D treatment (paricalcitol and cholecalciferol). METHODS: Sixty HD patients with serum parathyroid hormone (iPTH) >300 pg/mL were enrolled. All patients administered 2 mcg/day of paricalcitol and were randomly…

The Vitamin D Assessment (ViDA) Study: design of a randomized controlled trial of vitamin D supplementation for the prevention of cardiovascular disease, acute respiratory infection, falls and non-vertebral fractures.

Observational studies have shown that low vitamin D status is associated with an increased risk of cardiovascular disease, acute respiratory … f 438 participants returned for annual collection of blood samples to monitor adherence and safety (hypercalcemia), including repeat physical measurements at 12 months follow-up. The trial will allow testing of a priori hypotheses on several other endpoints including: weight, blood pressure, arterial waveform parameters, heart rate variability, lung function, m …

Minimally invasive resection for mediastinal ectopic parathyroid glands.

BACKGROUND: We reviewed our experience with ectopic mediastinal parathyroidectomy. METHODS: Between March 1980 and September 2010, mediastinal parathyroidectomy was performed in 33 patients with hypercalcemia secondary to hyperparathyroidism. RESULTS: Primary hyperparathyroidism was the main diagnosis in 32 patients (97%). Technetium-sestamibi scan was used in 23 (70%) for preoperative localization. Minimally invasive resections were performed in 18 patients (55%), and 15 (45%) underwent open surgery. The most common minimally invasive surgery approach was video-assisted thoracoscopy in 9 pa…

Klotho lacks a vitamin D independent physiological role in glucose homeostasis, bone turnover, and steady-state PTH secretion in vivo.

Apart from its function as co-receptor for fibroblast growth factor-23 (FGF23), Klotho is thought to regulate insulin signaling, intracellul … mutants, and were killed at 4 weeks of age after double fluorochrome labeling. Kl⁻/⁻ mice displayed hypercalcemia, hyperphosphatemia, dwarfism, organ atrophy, azotemia, pulmonary emphysema, and osteomalacia. In addition, glucose and insulin tolerance tests revealed hypoglycemia and profoundly increased peripheral insulin sensitivity in Kl⁻/⁻ mice. Compound muta …