TY - JOUR
T1 - A case of fatal osteolytic hypercalcemia complicated with IgG4-related ophthalmic disease leading to renal failure
AU - Kawakita, Chieko
AU - Kinomura, Masaru
AU - Gon, Yoshie
AU - Okita, Chika
AU - Katayama, Katsuyoshi
AU - Nishikawa, Mana
AU - Shimada, Noriaki
AU - Notohara, Kenji
AU - Fukushima, Masaki
AU - Asano, Kenichiro
PY - 2019/2/1
Y1 - 2019/2/1
N2 - A 40-year-old male was hospitalized with renal impairment and severe hypercalcemia. His concentration of serum IgG4 was high, but serum whole PTH, 1-25(OH)2 vitamin D3 and PTHrP were not elevated. Computed tomography showed swelling of the bilateral lacrimal glands and systemic lymphadenopathy. The histological findings of lacrimal gland biopsy fulfilled the diagnostic criteria of IgG4-related ophthalmic disease (IgG4ROD). Bone scintigraphy showed increased ectopic uptake in the stomach, heart, lungs, and kidneys. He died on day 16 of admission, although the therapies for hypercalcemia were continued. Autopsy results showed an increase of osteoclasts in the bone marrow and metastatic calcification in multiple organs, and excluded from the differential diagnosis other disorders which present lymph-node swelling and hypercalcemia such as cancer, lymphoma, Castleman's disease, and sarcoidosis. He was given a diagnosis of IgG4ROD with osteolytic hypercalcemia.
AB - A 40-year-old male was hospitalized with renal impairment and severe hypercalcemia. His concentration of serum IgG4 was high, but serum whole PTH, 1-25(OH)2 vitamin D3 and PTHrP were not elevated. Computed tomography showed swelling of the bilateral lacrimal glands and systemic lymphadenopathy. The histological findings of lacrimal gland biopsy fulfilled the diagnostic criteria of IgG4-related ophthalmic disease (IgG4ROD). Bone scintigraphy showed increased ectopic uptake in the stomach, heart, lungs, and kidneys. He died on day 16 of admission, although the therapies for hypercalcemia were continued. Autopsy results showed an increase of osteoclasts in the bone marrow and metastatic calcification in multiple organs, and excluded from the differential diagnosis other disorders which present lymph-node swelling and hypercalcemia such as cancer, lymphoma, Castleman's disease, and sarcoidosis. He was given a diagnosis of IgG4ROD with osteolytic hypercalcemia.
KW - Hypercalcemia
KW - IgG4-related disease
KW - Metastatic calcification
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U2 - 10.1007/s13730-018-0358-6
DO - 10.1007/s13730-018-0358-6
M3 - Article
C2 - 30109565
AN - SCOPUS:85060948198
SN - 2192-4449
VL - 8
SP - 23
EP - 30
JO - CEN case reports
JF - CEN case reports
IS - 1
ER -
