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A case of hypercalcemia associated with Castleman disease

Terri Washington1, Avni Vora, Dan Mihailescu

  • 1Department of Internal Medicine, University of Illinois Chicago, Chicago, IL, USA. twashi@att.net

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
|November 3, 2010
PubMed

Insights

This case report details severe hypercalcemia in a patient with Castleman disease, a rare lymphoproliferative disorder. The findings suggest a link between Castleman disease and elevated calcium levels, potentially mediated by inflammatory cytokines.

Area of Science:

  • Endocrinology
  • Oncology
  • Rheumatology

Background:

  • Castleman disease is a rare lymphoproliferative disorder with diverse clinical presentations.
  • Hypercalcemia is a significant metabolic disturbance that can be associated with various underlying conditions.

Observation:

  • A 25-year-old woman presented with severe hypercalcemia, joint pain, conjunctival injection, and lymphadenopathy.
  • Initial evaluations ruled out common causes of hypercalcemia, including primary hyperparathyroidism, infections, and rheumatologic conditions.
  • Whole-body bone scan revealed a metabolic superscan pattern, indicating increased bone turnover.

Findings:

  • Biopsy confirmed multicentric Castleman disease as the underlying diagnosis.
  • This is the first reported case of hypercalcemia associated with Castleman disease.
  • The hypercalcemia is hypothesized to be driven by cytokine-mediated bone turnover, particularly interleukin-6.

Implications:

  • This case expands the known clinical spectrum of Castleman disease.
  • It highlights the importance of considering Castleman disease in the differential diagnosis of unexplained hypercalcemia.
  • Understanding the cytokine-driven mechanism may inform future therapeutic strategies for managing hypercalcemia in Castleman disease.
Abstract

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