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J Pak Med Assoc 2019 Apr;69(4):600

Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.

Metastatic calcification relates to abnormal calcification resulting from hypercalcaemia in otherwise normal tissues. Hypercalcaemia can occur secondary to chronic renal failure, hyperparathyroidism, hypervitaminosis D, and metastatic neoplasms. Specific symptoms are often lacking, but calcification may be a marker of disease severity and its chronicity. Read More

Future Med Chem 2019 Apr 18. Epub 2019 Apr 18.

Department of Medicinal Chemistry, China Pharmaceutical University, Nanjing 210009, PR China.

Parathyroid hormone-1 receptor (PTH1R) is a member of B G protein-coupled receptors. The agonistic activation of the PTH1R results in the production and secretion of osteoclast-stimulating cytokines while antagonists may be used to treat bone metastases, hypercalcemia, cachexia and hyperparathyroidism. We built pharmacophore models and investigated the characteristics of PTH1R agonists and antagonists. Read More

Clin Case Rep 2019 Apr 5;7(4):849-850. Epub 2019 Mar 5.

Department of Endocrinology, the Second Affiliated Hospital Chongqing Medical University Chongqing China.

We report a case of hyperparathyroidism with hypercalcemia caused by a giant parathyroid adenoma. We use a technetium sestamibi scan to locate parathyroid mass. Bone emission computed tomography revealed the classic signs of metabolic osteopathy. Read More

Intern Med 2019 Apr 17. Epub 2019 Apr 17.

Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Japan.

Hypomagnesemia, a side effect of proton-pump inhibitors (PPIs), can be asymptomatic. The presence of hypocalcemia or hypokalemia is indicative of hypomagnesemia; however, the concomitant use of PPIs and thiazide may mask hypocalcemia. A 79-year-old woman with a history of chronic heart failure and chronic kidney disease developed symptomatic hypocalcemia and hypomagnesemia. Read More

JCI Insight 2019 Apr 18;4(8). Epub 2019 Apr 18.

Department of Endocrinology and Nephrology, The University of Tokyo School of Medicine, Tokyo, Japan.

Biased agonism is a paradigm that may explain the selective activation of a signaling pathway via a GPCR that activates multiple signals. The autoantibody-induced inactivation of the calcium-sensing receptor (CaSR) causes acquired hypocalciuric hypercalcemia (AHH). Here, we describe an instructive case of AHH in which severe hypercalcemia was accompanied by an increased CaSR antibody titer. Read More

J Clin Endocrinol Metab 2019 Apr 16. Epub 2019 Apr 16.

Department of Clinical Research, Faculty of Health, University of Southern Denmark (SDU).

Context: The clinical phenotype of multiple endocrine neoplasia type 4 (MEN4) is undefined due to a limited number of published cases. Knowledge on disease manifestation in MEN4 is essential for developing prevention programs and treatment.

Objective: To expand current knowledge of the MEN4 phenotype including assessment of penetrance. Read More

Clin Nephrol 2019 Apr 16. Epub 2019 Apr 16.

Background: Hypercalcemia and bone mineral density (BMD) loss are serious problems associated with post-transplant chronic kidney disease-mineral and bone disorder. The present study aimed to clarify the effects of denosumab on hypercalcemia complicated with BMD loss in kidney transplant recipients.

Materials And Methods: Among 100 consecutive adult kidney transplant recipients, 16 patients with serum corrected Ca (cCa) levels ≥ 11. Read More

Sultan Qaboos Univ Med J 2018 Nov 28;18(4):e533-e536. Epub 2019 Mar 28.

Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman.

The coexistence of cystic fibrosis (CF) and sarcoidosis is rare. We report a 22-year-old male cystic fibrosis patient who presented multiple times to the Sultan Qaboos University Hospital, Muscat, Oman, in 2013. He was diagnosed with non-parathyroid-related hypercalcaemia and anterior uveitis, while computed tomography revealed mediastinal and abdominal lymphadenopathy and mild hepatosplenomegaly. Read More

Headache 2019 Apr 15. Epub 2019 Apr 15.

Department of Clinical Neurosciences & Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

Equine Vet J 2019 Apr 13. Epub 2019 Apr 13.

Baker Institute for Animal Health, Cornell University College of Veterinary Medicine, Ithaca, New York, 14853, USA.

Background: Primary hyperparathyroidism is uncommon in equids.

Objectives: To describe the diagnostic findings and efficacy of treatment in equids with primary hyperparathyroidism.

Study Design: Retrospective case series describing sixteen horses and one mule. Read More

J Biol Chem 2019 Apr 12. Epub 2019 Apr 12.

Cardiovascular and Metabolic Disorders Program, Duke NUS Medical School, Singapore.

Primary hyperparathyroidism (PHPT) is a common endocrinopathy characterized by hypercalcemia and elevated levels of parathyroid hormone. The primary cause for PHPT is a benign overgrowth of parathyroid tissue causing excessive secretion of parathyroid hormone. However, the molecular etiology of PHPT is incompletely defined. Read More

Joint Bone Spine 2019 Apr 9. Epub 2019 Apr 9.

Rheumatology Department, Cochin Hospital, 75014 Paris, France; INSERM U1153, 75014 Paris France. Electronic address:

Objective: To evaluate the prevalence of biological abnormalities leading to secondary osteoporosis in recently fractured patients.

Methods: Adults older than 50, hospitalized for a nonvertebral fracture from July 2015 to October 2016, were assessed for bone fragility contributors in the Orthopedics Department. Bone mineral density (BMD) measurements and Vertebral Fracture assessment (VFA) were performed within 3 months. Read More

J Clin Endocrinol Metab 2019 Apr 12. Epub 2019 Apr 12.

Assistant Professor, Department of Endocrinology, Diabetes and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.

J Int Med Res 2019 Apr 10:300060519841156. Epub 2019 Apr 10.

1 Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China.

Clinical doctors rarely associate hyperparathyroidism with significant bradyarrhythmia. We report a rare case of a patient initially misdiagnosed with primary sick sinus syndrome, which was eventually shown to be secondary to primary hyperparathyroidism. Read More

Toxins (Basel) 2019 Apr 9;11(4). Epub 2019 Apr 9.

Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplant Unit, S. Orsola Hospital, University of Bologna, 40138 Bologna, Italy.

Vascular calcification (VC) is common in dialysis and non-dialysis chronic kidney disease (CKD) patients, even in the early stage of the disease. For this reason, it can be considered a CKD hallmark. VC contributes to cardiovascular disease (CVD) and increased mortality among CKD patients, although it has not been proven. Read More

Eur J Endocrinol 2019 May;180(5):311-320

Internal Medicine, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, Orbassano, University of Turin, Turin, Italy.

Introduction Adrenocortical carcinoma (ACC) is a rare cancer that commonly spreads to the liver, lungs and lymph nodes. Bone metastases are infrequent. Objective The aim of this report was to describe the clinical characteristics, survival perspective, prognostic factors and frequency of adverse skeletal-related events (SREs) in patients with ACC who developed bone metastasis. Read More

J Oral Maxillofac Pathol 2019 Feb;23(Suppl 1):87-89

Loma Linda University Medical Center, Loma Linda, CA, USA.

Pseudovascular squamous cell carcinoma (SCC) is a rare variant of SCC characterized by acantholysis and necrosis with preservation of vascular-like cords and spaces mimicking glands or vascular differentiation. Only three cases of this variant in the oral cavity have been reported in the literature. However, none of these cases were eosinophil-rich, which is considered to be a good prognostic indicator for conventional SCC. Read More

Intern Med J 2019 Apr 9. Epub 2019 Apr 9.

Department of Internal Medicine, Logan Hospital, Brisbane, QLD, Australia.

Background: Type 1 myotonic dystrophy (DM1) patients have a higher incidence of hypercalcemia compared to the general population. The nature and effects of dysregulated calcium metabolism underpinning this phenomenon have not been fully characterised.

Aims: To determine the characteristics of dysregulated calcium metabolism in DM1 patients and its association with bone mineral density. Read More

J Obstet Gynaecol India 2019 Apr 2;69(Suppl 1):60-62. Epub 2018 Feb 2.

1Department of Radiotherapy and Oncology, Government Medical College and Hospital, Chandigarh, India.

Objective: Small cell carcinoma of ovary, hypercalcemic type is a rare malignancy with a dismal prognosis. The diagnosis is often confused with many other tumors.

Case Report: We describe a rare case of ovarian small cell carcinoma of hypercalcemic type in an adolescent. Read More

J Clin Virol 2019 Mar 21;115:11-17. Epub 2019 Mar 21.

Central Virology Laboratory, Ministry of Health, Chaim Sheba Medical Center, Ramat-Gan, 52621, Israel; Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address:

Background: Human rhinoviruses (hRV) are small, RNA viruses of the Picornaviridae family, which are divided into three subtypes (A, B, C). hRVs are among the most common causes for acute respiratory illnesses (ARI) involving both the upper and lower respiratory tract.

Objectives: This study aimed to assess the magnitude and characteristics of hRV infections in hospitalized children, aged less than 5 years, hospitalized in Israel during 2011-2012. Read More

Cir Cir 2019 ;86(1):72-76

Rehabilitation Medicine, Faculty of Medicine, Universidad de Guanajuato. León, Gto., Mexico.

Background: Neurological paraneoplastic syndromes are rare, occur in 0.01% of all cancer patients; like part of them, the Lambert-Eaton syndrome is an autoimmune presynaptic disorder of neuromuscular transmission characterized by muscle weakness and neurovegetative dysfunction, and often associated with small cell lung cancer.

Case Report: A 72 years old female with a family history of lung cancer and leukemia, with 7 months of dry cough and 3 months with waist and pelvic muscle weakness, oropharyngeal dysphagia, dry mouth, chronic constipation and weight loss of 10 kg. Read More

Cir Cir 2019 ;86(1):96-98

Department of General and Digestive System Surgery, Hospital General Universitario Reina Sofía, Murcia, Spain.

Introduction: Hypercalcemia can cause different neurological disorders, depending on the calcium level. We report an exceptional case of primary hyperparathyroidism presenting as neurological alteration and it has favourable outcome after parathyroidectomy.

Case Report: A 74-year-old woman presented with progressive cognitive deterioration and impaired motor function. Read More

Ann Pediatr Endocrinol Metab 2019 Mar 31;24(1):64-67. Epub 2019 Mar 31.

Department of Pediatrics, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.

Idiopathic infantile hypercalcemia is characterized by hypercalcemia, dehydration, vomiting, and failure to thrive, and it is due to mutations in 24-hydroxylase (CYP24A1). Recently, mutations in sodium-phosphate cotransporter (SLC34A1) expressed in the kidney were discovered as an additional cause of idiopathic infantile hypercalcemia. This report describes a female infant admitted for evaluation of nephrocalcinosis. Read More

Int J Surg Case Rep 2019 Mar 21;57:106-109. Epub 2019 Mar 21.

Anatomy and Histology Laboratory, School of Nursing, University of Athens, Greece; University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece.

Introduction: Ectopic parathyroid glands occur in 6-16% of cases of PHPT and they constitute a potential cause of failed primary surgical therapy. In particular, aberrant adenomas located deeper in the mediastinum, as in the presented case, remain a severe challenge for the surgeons.

Presentation Of Case: A 54-year-old Caucasian female proceeded to our institution with signs and symptoms of PHPT. Read More

Mol Imaging Radionucl Ther 2019 Mar;28(1):41-43

University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Pathology, Ankara, Turkey

A 52-year-old woman presented with a complaint of neck swelling. The patient showed signs of hyperparathyroidism: hypercalcemia, and hypophosphatemia. Tc-99m MIBI dual-phase parathyroid scintigraphy and SPECT revealed increased activity in a regular-bordered, “doughnut”-shaped mass on the left side of the thyroid gland with a central hypoactive area. Read More

Nutrition 2019 Jan 30;63-64:120-125. Epub 2019 Jan 30.

Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.

Objectives: The presence of obesity may confound cholecalciferol dosing in vitamin D-deficient patients owing to potentially decreased bioavailability. The aim of this retrospective study was to evaluate cholecalciferol therapy in vitamin D-deficient, critically ill trauma patients with and without obesity.

Methods: Adult patients with severe traumatic injuries who had a serum 25-hydroxyvitamin D (25-OH vit D) <50nmol/L were prescribed 10 000 IU of liquid cholecalciferol daily. Read More

Acta Medica (Hradec Kralove) 2019 ;62(1):1-5

Nuclear Medicine Department, University Hospital Hradec Králové, Czech Republic.

Introduction: Preoperative parathyroid imaging is inevitable part of focused parathyroid surgery. The aim of our study was assessment of parathyroid scintigraphy diagnostic accuracy regarding to size and metabolic parameters of hyperfunctioning parathyroid tissue.

Material And Methods: Parathyroid scintigraphy for suspected primary hyperparathyroidism was performed in 95 patients during years 2015 and 2016. Read More

Rinsho Shinkeigaku 2019 Mar 30. Epub 2019 Mar 30.

Department of Internal Medicine, Division of Neurology, Hyogo College of Medicine.

A 73-year-old man was hospitalized with complaints of general malaise, limb muscle weakness and weight loss progressing in 6 months. Ca, ACE, lysozyme, sIL-2R, vitamin 1.25 D was high in the blood test. Read More

Physiol Rep 2019 Apr;7(7):e14045

Renal Research Institute, New York City, New York.

Altered parathyroid gland biology in patients with chronic kidney disease (CKD) is a major contributor to chronic kidney disease-mineral bone disorder (CKD-MBD). This disorder is associated with an increased risk of bone disorders, vascular calcification, and cardiovascular events. Parathyroid hormone (PTH) secretion is primarily regulated by the ionized calcium concentration as well as the phosphate concentration in the extracellular fluid and vitamin D. Read More

Am J Case Rep 2019 Mar 28;20:402-405. Epub 2019 Mar 28.

Department of Pediatrics, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.

BACKGROUND Malignant hypercalcemia is a rare finding in the pediatric population, even more rare in hematological malignancies, such as leukemia. CASE REPORT We present a case of a 6-year-old female patient who was diagnosed with acute lymphoblastic leukemia, with secondary hypercalcemia. She started chemotherapy following the IC-BFM ALL2002 protocol with simultaneous calcitonin, diuretics and aggressive hydration for hypercalcemia, and went into complete remission after the induction therapy. Read More

J Clin Exp Hematop 2019 ;59(1):22-28

Hypercalcemia due to malignant tumors including malignant lymphomas is relatively common. Among cancer patients with hypercalcemia, humoral hypercalcemia of malignancy is the most common and accounts for about 80% of all cases with hypercalcemia. 1,25-dihydroxyvitamin D(1,25(OH)D)-mediated hypercalcemia is relatively rare. Read More

Int J Artif Organs 2019 Mar 28:391398819837546. Epub 2019 Mar 28.

1 Division of Nephrology, Shanghai Pudong Hospital, Fudan University, Pudong Medical Center, Shanghai, China.

Introduction:: Patients with maintenance hemodialysis have experienced long-standing sleep disturbance. In this study, we attempted to explore whether long-term hemoperfusion could improve sleep and increase the overall survival in hemodialysis patients.

Methods:: A total of 158 patients, who underwent routine hemodialysis, were assessed in this study. Read More

Int J Mol Sci 2019 Mar 26;20(6). Epub 2019 Mar 26.

Hochwaldstrasse 2, D-97769 Bad Brückenau, Germany.

The excellent publication by Häusler and Weber [... Read More

Arch Endocrinol Metab 2019 Mar 21. Epub 2019 Mar 21.

Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brasil.

Objective: To define serum parathyroid hormone (PTH) reference values in carefully selected subjects following the recommended pre-analytical guidelines.

Subjects And Methods: First, 676 adults who would be submitted to thyroidectomy were evaluated. Patients using interfering medications or with malabsorption syndrome, hypomagnesemia, hyper- or hypophosphatemia, hypo- or hypercalcemia, 25-hydroxyvitamin D < 30 ng/dL, estimated glomerular filtration rate < 60 mL/min/1. Read More

J Family Med Prim Care 2019 Jan;8(1):296-298

Department of Medicine, RPGMC Tanda at Kangra, Himachal Pradesh, India.

Nephrocalcinosis is a rare condition in clinical practice where there is an increased renal deposition of calcium. Varied causes of this condition have been given in literature, and tuberculosis (TB) has been an important one. Hypercalcemia is a known complication of granulomatous diseases. Read More

Semin Diagn Pathol 2019 Mar 18. Epub 2019 Mar 18.

Department of Pathology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114-2696, United States. Electronic address:

Neuroendocrine paraneoplastic syndromes (PNS) consist of metabolic disorders that accompany benign and malignant neoplasms but remain unrelated to mass effects or invasion by the primary tumor or its metastases. The underlying pathogenesis responsible for PNS usual clinical presentation rely on aberrant production of protein hormones, proteins and other substances by the tumor. Prompt recognition of characteristic signs and symptoms combined with serological identification of key substances may result in early diagnosis of PNS and its underlying malignancy. Read More

Ren Fail 2019 Nov;41(1):88-97

a Division of Kidney Center , Matsuyama Red Cross Hospital , Matsuyama , Japan.

Background: Eldecalcitol (ELD) is an active vitamin D analog that is widely used in Japan for the treatment of osteoporosis. The most common adverse drug reaction of ELD is hypercalcemia. However, few reports have focused on acute kidney injury (AKI) associated with ELD-induced hypercalcemia. Read More

BJU Int 2019 Mar 25. Epub 2019 Mar 25.

Guy's & St Thomas, NHS Foundation Trust, Urology, London, United Kingdom of Great Britain and Northern Ireland.

Objectives: To evaluate contemporary oncological outcomes and long term survival in patients undergoing surgery for urological tumours involving the peridiaphragmatic inferior vena cava up to the level of the right atrium. To apply prognostic factors developed in metastatic renal cancer to patients with very high risk but apparently localized tumours, and develop a scoring system.

Patients And Methods: A retrospective cohort study of 54 patients referred between December 2007 and April 2018 to a single surgical and oncological team. Read More

Expert Rev Hematol 2019 Mar 25:1-10. Epub 2019 Mar 25.

b School of Medicine , Complutense University , Madrid , Spain.

Introduction: In 2014, the International Myeloma Working Group determined that patients with ultra-high-risk smoldering multiple myeloma (SMM) should be considered for treatment as per patients with symptomatic multiple myeloma (MM), despite not having CRAB (hyperCalcemia, Renal insufficiency, Anemia, Bone disease) symptoms. Current research is elucidating whether patients with high-risk, and even intermediate-risk, SMM could benefit from early therapeutic strategies aimed at delaying progression to active MM and prolonging survival. Areas covered: The authors conducted a systematic literature search using PubMed to identify a series of patients with SMM in which prognostic and predictive factors for progression were investigated, plus the main clinical trials in SMM. Read More

Hormones (Athens) 2019 Mar 23. Epub 2019 Mar 23.

Endocrinology, Department of Clinical and Experimental Medicine, Garibaldi-Nesima Hospital, University of Catania, Via Palermo 636, 95122, Catania, Italy.

Introduction: Parathyroid carcinoma (PC) is a rare neoplasm with a high rate of recurrence and an indolent course. It is frequently functional, causing nearly 1% of the cases of primary hyperparathyroidism (HPT), and in some cases, it may be complicated by brown tumors, mimicking bone metastases. Synchronous parathyroid and papillary thyroid carcinomas are rare. Read More

Clin Chem Lab Med 2019 Mar 23. Epub 2019 Mar 23.

Amsterdam UMC, Vrije Universiteit Amsterdam, Endocrine Laboratory, Department of Clinical Chemistry, de Boelelaan 1117, Amsterdam, The Netherlands.

J Cancer Res Ther 2019 Mar;15(Supplement):S170-S172

Department of Medical Oncology, Akdeniz University School of Medicine, Antalya, Turkey.

Renal pelvis squamous cell carcinoma (RSCC) is a rare tumor. It starts with nonspecific symptoms and it is usually at an advanced stage with a poor prognosis at the time of diagnosis. SCC-associated hypercalcemia is a well-known paraneoplastic syndrome; however RSCC-associated hypercalcemia is a rare condition. Read More

Vet Med Sci 2019 Mar 21. Epub 2019 Mar 21.

Veterinary Specialty Center of Delaware, Newcastle, Delaware, USA.

Oncological emergencies can occur at any time during the course of a malignancy and need to be recognized promptly to maximize successful outcomes. Emergencies are characterized as chemotherapy-induced, paraneoplastic syndromes, or directly related to the neoplasm. Prompt identification with treatment of these emergencies can prolong survival and improve quality of life, even in the setting of terminal illness. Read More

Kidney Int Rep 2019 Mar 19;4(3):487-490. Epub 2018 Nov 19.

Department of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA.

Br J Nutr 2019 Apr 22;121(8):859-865. Epub 2019 Mar 22.

3Department of Dermatology,All India Institute of Medical Sciences,New Delhi 110 029,India.

Nanoemulsion formulation of vitamin D3 have been shown to have better bioavailability than the coarse emulsion preparation in vitro and in vivo animal studies. In the absence of randomised trial in humans, comparing the efficacy of nanotechnology-based miscellised vitamin D3 over conventional vitamin D3, we undertook this study. A total of 180 healthy adults were randomised to receive either micellised (DePura, group A) or conventional vitamin D3 (Calcirol, group B) at a monthly dose of 60 000 IU (1500μg) for 6 months. Read More

Case Rep Endocrinol 2019 13;2019:9468252. Epub 2019 Feb 13.

Department of Clinical Biochemistry, Copenhagen University Hospital Hvidovre, Denmark.

Heterozygous inactivating mutations in the calcium-sensing receptor (CaSR) gene are known to cause familial hypocalciuric hypercalcemia (FHH), usually a benign form of hypercalcemia without symptoms of a disrupted calcium homeostasis. FHH can be mistaken for the more common primary hyperparathyroidism (PHPT), for which surgical treatment may be needed. We describe a case of a 36-year-old woman with hypercalcemia and elevated PTH, initially suspected of having PHPT. Read More

Public Health Nutr 2019 Mar 21:1-11. Epub 2019 Mar 21.

2Department of Cardiology,The First Hospital of China Medical University,155 Nanjing Bei Street, Shenyang110001,Liaoning,People's Republic of China.

Objective: The present epidemiological study aimed to evaluate the association of serum electrolyte levels with hypertension in a population with a high-salt diet.

Design: Secondary analysis of epidemiology data from the Northeast China Rural Cardiovascular Health Study conducted in 2012-2013. Blood pressure and hypertension status were analysed for association with serum sodium, potassium, chloride, total calcium, phosphate and magnesium levels using regression models. Read More

Transpl Infect Dis 2019 Mar 20:e13081. Epub 2019 Mar 20.

Department of Internal Medicine, Division of Infectious Disease, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

Vitamin D-mediated hypercalcemia is an uncommon complication of Pneumocystis infection. A granulomatous response resulting from Pneumocystis infection is also atypical. In this report, we describe an exceptional case of granulomatous Pneumocystis pneumonia associated with vitamin D-mediated hypercalcemia, in a patient who presented unusually late after renal transplantation. Read More

Am J Case Rep 2019 Mar 20;20:366-369. Epub 2019 Mar 20.

Division of Surgical Oncology, Rush University Medical Center, Chicago, IL, USA.

BACKGROUND Metaplastic breast carcinoma is a rare entity characterized by rapid growth and heterogeneous histological features. It comprises less than 1% of all breast cancers, and no definitive treatment has yet been identified. CASE REPORT We describe here a patient who presented with acute hypercalcemia and was found to have a large ulcerated breast mass. Read More

BMC Rheumatol 2018 3;2:34. Epub 2018 Nov 3.

3Department of Rheumatology, Immunology and Rehabilitation, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

Background: We report the case of a patient with rheumatoid arthritis (RA) treated with tofacitinib who developed severe pneumonia (PJP) with an atypical clinical presentation.

Case Presentation: A 78-year old male patient with RA treated with tofacitinib, methotrexate (MTX) and low dose corticosteroids was admitted to the hospital with arthralgia and nausea. Laboratory findings revealed hypercalcemia with normal levels of parathyroid hormone (PTH) and elevated 1,25-(OH) vitamin D levels. Read More