Tsujimura H, Nagamura F, Iseki T, Kanazawa S, Saisho H
First Department of Internal Medicine, Chiba University, School of Medicine, Japan.
Am J Hematol. 1998 Oct;59(2):168-70. doi: 10.1002/(sici)1096-8652(199810)59:2<168::aid-ajh11>3.0.co;2-5.
Elevated levels of parathyroid hormone-related protein (PTHrP) in hypercalcemic myeloma patients were demonstrated in recent reports, suggesting that PTHrP behaves as a humoral mediator of hypercalcemia in myeloma. Herein we describe a hypercalcemic myeloma patient with a high serum PTHrP level. Moreover, the PTHrP level in the supernatant of bone marrow aspirates was about two-fold of that in serum. Reverve transcriptase-polymerase chain reaction analysis showed PTHrP m-RNA in bone marrow containing myeloma cells. After chemotherapy, the concentrations of calcium and PTHrP decreased and PTHrP mRNA in bone marrow became undetectable. We conclude that PTHrP released by myeloma cells acted as the main bone resorption stimulating factor in this case.
最近的报告显示，高钙血症骨髓瘤患者的甲状旁腺激素相关蛋白（PTHrP）水平升高，这表明PTHrP在骨髓瘤中作为高钙血症的体液介质发挥作用。在此，我们描述了一名血清PTHrP水平高的高钙血症骨髓瘤患者。此外，骨髓穿刺液上清液中的PTHrP水平约为血清中的两倍。逆转录聚合酶链反应分析显示，含有骨髓瘤细胞的骨髓中有PTHrP mRNA。化疗后，钙和PTHrP的浓度降低，骨髓中的PTHrP mRNA无法检测到。我们得出结论，在这种情况下，骨髓瘤细胞释放的PTHrP是主要的骨吸收刺激因子。
