Humoral hypercalcemia in Hodgkin's disease. Clinical and laboratory evaluation

Correlation of Calcium and Magnesium Levels in the Biological Samples of Different Types of Acute Leukemia Children

Acute leukemia (AL) is a common childhood malignancy. It is clinically and morphologically heterogeneous. The present work was intended to estimate the concentration of calcium (Ca) and magnesium (Mg) in serum and whole blood samples of children having AL; 1- to 5- and 6- to 10-year-old children age group was chosen of both genders. Healthy children of the same age group were selected as controls for comparative study. For sample pretreatment, a microwave-assisted acid digestion (MAD) was carried out, to assess the concentration of Ca and Mg in biological samples of AL children. The MAD method was validated by analyzing Clinchek® Control certified samples of whole blood and serum. Ca and Mg were analyzed in the digested samples by flame atomic absorption spectrometry (FAAS). The results showed significantly higher concentration of Ca, whereas lower contents of Mg in the serum and whole blood of AL children in both genders, as compared to healthy subjects. The data provide assistance to physician/clinicians and other professional staffs to investigate the imbalance of minerals in biological samples of AL children.

Imaging in the investigation of paraneoplastic syndromes

Paraneoplastic syndromes are a heterogeneous group of disease presentations caused by underlying tumours. As they are non-metastatic in nature an intensive diagnostic evaluation is warranted to identify potentially curable lesions. The selection of the appropriate method of imaging is important in these cases, especially when history and physical examination are unrevealing. In this review the important paraneoplastic syndromes and underlying malignancies are discussed along with relevant imaging strategies.

Hypercalcaemia in Hodgkin's disease related to prostaglandin synthesis

A case of paraneoplastic hypercalcaemic syndrome is reported in a patient with Hodgkin's disease. This was detected eight months before widespread lymphadenopathy became apparent. Lymphocyte depleted Hodgkin's disease was diagnosed. PTH (parathyroid hormone) activity was suppressed and PTHRP (PTH related protein) was less than 5 pmol/l. 1,25(OH)2D3 was in the normal range. Plasma calcium values returned to normal after the administration of indomethacin. Thus the pathogenesis of the hypercalcaemia in this patient could be associated with the synthesis of prostaglandins.

Hypertension as a paraneoplastic phenomenon in childhood Hodgkin's disease

A 14 year old girl with Hodgkin's disease presented with hypertension as an unusual paraneoplastic phenomenon. The elevated plasma renin activity recorded in this patient was possibly a result of Hodgkin's disease. Hypertension as well as plasma renin activity declined to normal values following her successful response to chemotherapy.

Parathyroid hormone related protein in hypercalcaemia of Hodgkin's disease

The role of parathyroid hormone related protein (PTHRP) as a humoral mediator of hypercalcaemia was investigated in a patient with lymphocyte depleted Hodgkin's disease during an episode of hypercalcaemia, using an immunohistochemical staining technique for PTHRP on the tumour tissue and an immunoradiometric (IRMA) assay for PTHRP1-86 on the patient's plasma. The plasma PTHRP was less than 0.23 pmol/l in the range found in normocalcaemic controls, and the immunohistochemical staining was not positive for protein. PTHRP did not have a role in the pathogenesis of hypercalcaemia in this patient.

[Bone localizations disclosing Hodgkin's disease. Apropos of 11 cases]

The authors report 11 cases of Hodgkin's disease in which the first sign was due to bone involvement. Such observations are rare and raise diagnosis delays (Means: 5, 6 months in this series). Modern medical imaging techniques (scintigraphy, CT scan, magnetic resonance imaging) are very useful to an earlier diagnosis which will be better confirmed by lymph node biopsy given the poor information yielded by osseous cytology and/or histology. The elective localisation in bones belonging to the axial skeleton seems to support the hypothesis of a contiguous osseous involvement from lymphoïd organs in contact with bones. Evolution with chemotherapy and radiotherapy is very similar to that observed in patients without bone involvement.