Parathyroid Hormone-related Peptide-producing Multiple Myeloma and Renal Impairment

Masaru Kinomura; Noriaki Shimada; Mana Nishikawa; Kazuyoshi Omori; Tomoyasu Jo; Yasunori Ueda; Kenji Notohara; Riko Kitazawa; Sohei Kitazawa; Masaki Fukushima; Kenichiro Asano

doi:10.2169/internalmedicine.54.5085

CASE REPORTS

Parathyroid Hormone-related Peptide-producing Multiple Myeloma and Renal Impairment

Masaru Kinomura, Noriaki Shimada, Mana Nishikawa, Kazuyoshi Omori, Tomoyasu Jo, Yasunori Ueda, Kenji Notohara, Riko Kitazawa, Sohei Kitazawa, Masaki Fukushima, Kenichiro Asano

Author information

Masaru Kinomura
Department of Nephrology, Kurashiki Central Hospital, Japan
Noriaki Shimada
Department of Nephrology, Kurashiki Central Hospital, Japan
Mana Nishikawa
Department of Nephrology, Kurashiki Central Hospital, Japan
Kazuyoshi Omori
Department of Nephrology, Kurashiki Central Hospital, Japan
Tomoyasu Jo
Department of Haematology/Oncology, Kurashiki Central Hospital, Japan
Yasunori Ueda
Department of Haematology/Oncology, Kurashiki Central Hospital, Japan
Kenji Notohara
Department of Anatomic Pathology, Kurashiki Central Hospital, Japan
Riko Kitazawa
Department of Molecular Pathology, Ehime University Graduate School of Medicine, Japan
Sohei Kitazawa
Department of Molecular Pathology, Ehime University Graduate School of Medicine, Japan
Masaki Fukushima
Department of Internal Medicine, Shigei Medical Research Hospital, Japan
Kenichiro Asano
Department of Nephrology, Kurashiki Central Hospital, Japan

Keywords: cast nephropathy, light chain deposition disease, PTHrP

JOURNAL OPEN ACCESS

2015 Volume 54 Issue 23 Pages 3029-3033

DOI https://doi.org/10.2169/internalmedicine.54.5085

Details

Abstract

A 68-year-old man was hospitalized and examined for renal impairment. A laboratory analysis showed hypercalcemia. Although the serum parathyroid hormone and serum 1-25(OH)₂ vitamin D3 levels were not elevated, the serum parathyroid hormone-related peptide (PTHrP) level was increased. Immunoelectrophoresis of the urine and bone marrow aspiration indicated multiple myeloma (MM). He was diagnosed with the coexistence of cast nephropathy and light chain deposition disease by a renal biopsy. Notably, PTHrP expression was detected in the myeloma cells based on immunohistochemistry and in situ hybridization. It is therefore important to examine the PTHrP concentration in MM patients with hypercalcemia.

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