A Surinamese Woman with Severe Hypercalcemia and Ascites

Special Article: Adult T-cell Leukemia

J Blood Disord. 2023; 10(2): 1079.

A Surinamese Woman with Severe Hypercalcemia and Ascites

Jort A van Rij, MD1; Anton W Langerak, Prof2; Leo M Budel, MD, PhD3; Floor Weerkamp, PhD4; Jérôme Wayet5,6; Anne Van den Broeke, DVM, PhD5,6; Yorick Sandberg, MD, PhD1*

1Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands

2Department of Immunology Erasmus Medical Centre, Rotterdam, The Netherlands

3Department of Pathology, Maasstad Hospital, Rotterdam, The Netherlands

4Department of Clinical Chemistry, Maasstad Hospital, The Netherlands

5Laboratory of Viral Oncogenesis, Institut Jules Bordet, ULB, Brussels, Belgium

6Unit of Animal Genomics, GIGA, University of Liège, Liège, Belgium

*Corresponding author: Yorick Sandberg Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands. Tel: +31 (0) 10 2912640 Email: SandbergY@maasstadziekenhuis.nl

Received: July 11, 2023 Accepted: August 11, 2023 Published: August 18, 2023

Abstract

A 60-year-old Surinamese woman was admitted to the department of Hematology because of refractory hypercalcemia and weight loss. Three months earlier she presented with aphasia and ataxia due to hypercalcemia (4.32 mmol/L). She was treated with intravenous fluids, calcitonin and pamidronate, resulting in normocalcemia. Serum Parathyroid Hormone (PTH) was 1.93 pmol/L. At that time, a bone marrow and Peripheral Blood (PB) examination and Fluorodeoxyglucose-Positron Emission Tomography (FDG-PET) scan did not show any abnormalities. Physical examination revealed multiple papules and diffuse scaling (Figure 1A). Current PB analysis demonstrated anemia (10 g/dL), thrombocytopenia (103 x 109/L), leukocytosis (20.5x 109/L; 38% lymphocytes), hypercalcemia (3.58 mmol/L) and elevated LDH (652 U/L). FDG-PET/CT at this time point showed ascites and splenomegaly.