与矿物油诱导的硬化性石蜡瘤相关的高钙血症。
Hypercalcemia associated with mineral oil-induced sclerosing paraffinomas.
机构信息
Eunice Shriver Kennedy National Institute of Child Health and Human Development, National Institutes of Health (NIH), Bethesda, Maryland, USA.
出版信息
Endocr Pract. 2013 Mar-Apr;19(2):e50-6. doi: 10.4158/EP12092.CR.
OBJECTIVE
Granuloma-forming diseases such as sarcoidosis are associated with extrarenal synthesis of 1,25-dihydroxyvitamin D [1,25(OH)₂D]. We describe a case of extensive skin lesions associated with mineral oil injections in which we provide evidence for cutaneous granuloma synthesis of 1,25(OH)₂D in the pathogenesis of the patient's hypercalcemia.
METHODS
Analysis of expression of the 25(OH)D-1a-hydroxylase (1-a OHase [CYP27b1]) was carried out by immunohistochemical analysis of involved skin.
RESULTS
In involved skin, expression of CYP27b1 was found in the dermis, where it is not normally expressed. Successful management of hypercalcemia was achieved with glucocorticoids.
CONCLUSIONS
Hypercalcemia associated with mineral oil induced skin lesions is likely driven by unregulated expression of CYP27b1 by inflammatory monocytes and macrophages infiltrating the dermis.
目的
肉芽肿形成性疾病（如结节病）与肾脏外合成 1,25-二羟维生素 D [1,25(OH)₂D]有关。我们描述了一例与矿物油注射相关的广泛皮肤损伤病例，该病例为患者高钙血症的发病机制提供了皮肤肉芽肿合成 1,25(OH)₂D 的证据。
方法
通过对受累皮肤进行免疫组织化学分析，对 25(OH)D-1α-羟化酶（1-α羟化酶[CYP27b1]）的表达进行分析。
结果
在受累皮肤中，CYP27b1 在真皮中表达，而真皮中通常不表达。用糖皮质激素成功治疗了高钙血症。
结论
矿物油诱导的皮肤损伤相关的高钙血症可能是由浸润真皮的炎症性单核细胞和巨噬细胞不受调节地表达 CYP27b1 引起的。
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