Japp Emily Anne, Meron Michal Kasher, Zonszein Joel
AACE Clin Case Rep. 2019 Apr 25;5(3):e210-e213. doi: 10.4158/ACCR-2018-0479. eCollection 2019 May-Jun.
Adult T-cell leukemia/lymphoma (ATL) is known for its aggressive behavior, frequently presenting with hypercalcemia. ATL tumor cells uniquely secrete parathyroid hormone-related protein, viral peptides, and inflammatory cytokines, inducing a state of high bone turnover and activation of the receptor activator of nuclear factor kappa-B signaling pathway resulting in hypercalcemia.
A 54-year-old woman diagnosed with ATL presented with severe hypercalcemia refractory to bisphosphonate therapy. Treatment with denosumab was followed by protracted hypocalcemia and hypophosphatemia lasting approximately 5 months.
Hypercalcemia due to acute ATL was responsive in this case to denosumab therapy.
Clinicians should be aware of the possibility of protracted hypocalcemia in patients with ATL exposed to denosumab therapy.
成人T细胞白血病/淋巴瘤（ATL）以其侵袭性病程而闻名，常伴有高钙血症。ATL肿瘤细胞独特地分泌甲状旁腺激素相关蛋白、病毒肽和炎性细胞因子，引发高骨转换状态并激活核因子κB信号通路的受体激活剂，从而导致高钙血症。
一名54岁被诊断为ATL的女性出现严重高钙血症，对双膦酸盐治疗无效。使用地诺单抗治疗后出现持续约5个月的持续性低钙血症和低磷血症。
在该病例中，急性ATL所致的高钙血症对地诺单抗治疗有反应。
临床医生应意识到接受地诺单抗治疗的ATL患者可能出现持续性低钙血症。
