Hypercalcemia Associated with the Ectopic Expression of 25-hydroxyvitamin D3-1α-hydroxylase in Diffuse Large B-cell Lymphoma

Intern Med. 2022;61(16):2489-2495. doi: 10.2169/internalmedicine.8933-21. Epub 2022 Aug 15.

Abstract

An 82-year-old man was transferred to our hospital due to impaired consciousness. His albumin-corrected calcium level was 14.2 mg/dL, intact parathyroid hormone (PTH) and PTH-related protein levels were reduced, and his 1,25-dihydroxyvitamin D [1,25 (OH) 2VitD] level was elevated at 71.5 pg/mL. Computed tomography revealed masses on the bilateral ribs. The mass on the rib was biopsied and diagnosed as diffuse large B-cell lymphoma (DLBCL). Immunostaining of the biopsy sample with the anti-CYP27B1 antibody revealed the ectopic expression of 1α-hydroxylase in the lesion. We herein report a rare case of hypercalcemia induced by the overproduction of 1,25 (OH) 2VitD in DLBCL ectopically expressing 1α-hydroxylase.

Keywords: 1,25 (OH) 2VitD; 1α-hydroxylase; CYP27B1; calcium; lymphoma.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Calcifediol / adverse effects
  • Calcifediol / metabolism
  • Ectopic Gene Expression
  • Humans
  • Hypercalcemia* / chemically induced
  • Lymphoma, Large B-Cell, Diffuse* / complications
  • Male
  • Parathyroid Hormone / metabolism
  • Vitamin D / adverse effects

Substances

  • Parathyroid Hormone
  • Vitamin D
  • Calcifediol