Polycythemia Vera and Primary Hyperparathyroidism

Godeau, P

doi:10.1001/archinte.1981.00340070131030

Cited by 10 publications

(4 citation statements)

References 12 publications

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“…, 1991), meningioma (Bruneval et al. , 1993), parathyroid adenomas (Godeau et al. , 1981), hepatocellular carcinoma (Muta et al.…”

Section: Acquired Erythrocytosismentioning

confidence: 99%

“…High expression of EPO mRNA in the tumour tissue and correction of the erythrocytosis with a fall in EPO levels with removal of the tumour confirm the link between the tumour and erythrocytosis. Examples of conditions in which it has been described are cerebellar haemangioblastoma (Trimble et al, 1991), meningioma (Bruneval et al, 1993), parathyroid adenomas (Godeau et al, 1981), hepatocellular carcinoma (Muta et al, 1994;Matsuyama et al, 2000), renal cell carci-noma where there may be associated VHL mutations (Hama et al, 2005;Rad et al, 2008) pheochromocytoma (Dré nou et al, 1995) and uterine leiomyomas (Yoshida et al, 1999;Suzuki et al, 2001).…”

Section: Pathological Epo Productionmentioning

confidence: 99%

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The classification and diagnosis of erythrocytosis

McMullin

2008

Int J Lab Hematology

133

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Summary An absolute erythrocytosis is present when the red cell mass is raised and the haematocrit is elevated above prescribed limits. Causes of an absolute erythrocytosis can be primary where there is an intrinsic problem in the bone marrow and secondary where there an event outside the bone marrow driving erythropoiesis. This can further be divided into congenital and acquired causes. There remain an unexplained group idiopathic erythrocytosis. Investigation commencing with thorough history taking and examination and then investigation depending on initial features is required. Clear simple criteria for polycythaemia vera are now defined. Those who do not fulfil these criteria require further investigation depending on the clinical scenario and initial results. The erythropoietin level provides some guidance as to the direction in which to proceed and the order and extent of investigation necessary in an individual patient. It should thus be possible to make an accurate diagnosis in the majority of patients.

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“…, 1991), meningioma (Bruneval et al. , 1993), parathyroid adenomas (Godeau et al. , 1981), hepatocellular carcinoma (Muta et al.…”

Section: Acquired Erythrocytosismentioning

confidence: 99%

Section: Pathological Epo Productionmentioning

confidence: 99%

The classification and diagnosis of erythrocytosis

McMullin

2008

Int J Lab Hematology

133

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“…Hypercalcemia occurring by different mechanisms has been reported in association with polycythemia vera. Several studies have reported an association between polycythemia vera and primary hyperparathyroidism, with resolution of polycythemia following surgical removal of a parathyroid adenoma or a parathyroid carcinoma . These reports antedate JAK2 mutation testing, and these patients may possibly not have had polycythemia vera, but rather secondary polycythemia, with the parathyroid lesions possibly stimulating or secreting erythropoietin.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have reported an association between polycythemia vera and primary hyperparathyroidism, with resolution of polycythemia following surgical removal of a parathyroid adenoma or a parathyroid carcinoma. [5][6][7][8] These reports antedate JAK2 mutation testing, and these patients may possibly not have had polycythemia vera, but rather secondary polycythemia, with the parathyroid lesions possibly stimulating or secreting erythropoietin. An association between parathyroid adenomas and polycythemia vera was identified in a historical cohort study, 9 but it is again unclear whether these cases represented polycythemia vera or secondary polycythemia.…”

Section: Discussionmentioning

confidence: 99%

Development of Hypercalcemia in a Patient Receiving Peginterferon alfa‐2a Therapy for Polycythemia Vera

Karne

Mainor

2016

Pharmacotherapy

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Peginterferon alfa-2a (PEG-IFN alfa-2a) is commonly used to treat hepatitis C virus infection and is also being used increasingly to treat myeloproliferative neoplasms including polycythemia vera. Sarcoidosis associated with IFN therapy for treatment of hepatitis C is well described, with hypercalcemia occurring as a rare manifestation. We describe a 25-year-old man with polycythemia vera who became resistant to hydroxyurea after 6 years of treatment, requiring therapeutic phlebotomy procedures with increasing frequency for elevated hemoglobin and hematocrit levels. PEG-IFN alfa-2a was then initiated at 90 μg subcutaneously once/week and was progressively increased to 180 μg/week over the next 11 months, with normalization of his hemoglobin and hematocrit. The patient then developed hypercalcemia with low parathyroid hormone, parathyroid hormone-related protein, and 25-hydroxyvitamin D levels, and high 1,25-dihydroxyvitamin D and angiotensin-converting enzyme levels, without other evidence of sarcoidosis. PEG-IFN alfa-2a was discontinued, treatment with intravenous fluids and zoledronic acid was initiated, and the hypercalcemia resolved 10 weeks later. Use of the Naranjo Adverse Drug Reaction Probability Scale indicated a probable relationship (score of 7) between the patient's development of hypercalcemia and PEG-IFN alfa-2a therapy; the relationship could not be considered as definite because the patient was not rechallenged with the drug. To our knowledge, this is the first case report of IFN-induced hypercalcemia without other manifestations of sarcoidosis. Practitioners should be aware of hypercalcemia as a potential complication of PEG-IFN alfa-2a therapy, as well as its protracted time course, in patients with myeloproliferative neoplasms.

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The role of parathyroidectomy in JAK2 mutation negative polycythemia vera

2014

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The relationship between polycythemia vera (PV) and primary hyperparathyroidism is not well understood. Remission or improvement of PV following parathyroidectomy in the setting of primary hyperparathyroidism has previously been described; however, long-term outcomes are not well characterized. We describe a patient with JAK2 mutation negative PV and primary hyperparathyroidism, with a dramatic, but ultimately transient, improvement in hemoglobin following resection of a parathyroid adenoma. While screening for hyperparathyroidism may be useful in the setting of PV, indications for parathyroidectomy should be driven by symptomatology or established criteria, not the desire to affect the clinical course of PV.

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Polycythemia Vera and Primary Hyperparathyroidism

Cited by 10 publications

References 12 publications

The classification and diagnosis of erythrocytosis

The classification and diagnosis of erythrocytosis

Development of Hypercalcemia in a Patient Receiving Peginterferon alfa‐2a Therapy for Polycythemia Vera

The role of parathyroidectomy in JAK2 mutation negative polycythemia vera

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