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Hypercalcemia in Pheochromocytoma
Evidence for a Novel Mechanism
- ANDREW F. STEWART, M.D.;
- JAY L. HOECKER, M.D.;
- LAWRENCE E. MALLETTE, M.D., Ph.D.;
- GINO V. SEGRE, M.D.;
- THOMAS T. AMATRUDA, Jr., M.D.; and
- AGNES VIGNERY, D.D.S., Ph.D.
- West Haven, New Haven, Waterbury, and Farmington, Connecticut; Houston, Texas; and Boston, Massachusetts
Abstract
A child with a pheochromocytoma had hypercalcemia but no evidence for excessive parathyroid hormone secretion from the parathyroid glands or the pheochromocytoma. Therapy with the catecholamine synthesis inhibitor metyrosine (alpha-methyltyrosine) reversed the catecholamine excess but had no effect on the hypercalcemia. Adrenalectomy promptly reversed the hypercalcemia. Extracts of the tumor contained a substance(s) that produced both potent in-vitro bone resorption and striking adenylate-cyclase-stimulating activity in renal cortical membranes. This stimulating activity was due to activation of the parathyroid hormone receptor/adenylate cyclase complex but was not due to parathyroid hormone. Our findings document hypercalcemia in association with pheochromocytoma and show that hypercalcemia occurred in the absence of previously proposed mechanisms. We also provide preliminary characterization of the presumed responsible substance(s) and suggest that this substance(s) may be related to that associated with the humoral hypercalcemia of malignancy.
Article and Author Information
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▸From the Department of Internal Medicine, West Haven Veterans Administration Medical Center, West Haven, Connecticut; Departments of Internal Medicine and Cell Biology, Yale University School of Medicine, New Haven, Connecticut; Division of Endocrinology, Department of Internal Medicine, Baylor College of Medicine, and Houston Veterans Administration Medical Center, Houston, Texas; Endocrine Unit, Massachusetts General Hospital, Boston, Massachusetts; Waterbury Hospital, Waterbury, Connecticut; and Waterbury Regional Department of Pediatrics of the Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut.
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Grant support by the Veteran's Administration in West Haven, Connecticut, and Houston, Texas; and by grants AM 30102 and CA 33320 from the National Institutes of Health.
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▸Requests for reprints should be addressed to Andrew Stewart, M.D.; Fitkin 106, Yale University School of Medicine, 333 Cedar Street; New Haven, CT 06511.
- © 1985 American College of Physicians
