A case of fatal osteolytic hypercalcemia complicated with IgG4-related ophthalmic disease leading to renal failure

Chieko Kawakita, Masaru Kinomura, Yoshie Gon, Chika Okita, Katsuyoshi Katayama, Mana Nishikawa, Noriaki Shimada, Kenji Notohara, Masaki Fukushima, Kenichiro Asano

Research output: Contribution to journalArticle

Abstract

A 40-year-old male was hospitalized with renal impairment and severe hypercalcemia. His concentration of serum IgG4 was high, but serum whole PTH, 1-25(OH)2 vitamin D3 and PTHrP were not elevated. Computed tomography showed swelling of the bilateral lacrimal glands and systemic lymphadenopathy. The histological findings of lacrimal gland biopsy fulfilled the diagnostic criteria of IgG4-related ophthalmic disease (IgG4ROD). Bone scintigraphy showed increased ectopic uptake in the stomach, heart, lungs, and kidneys. He died on day 16 of admission, although the therapies for hypercalcemia were continued. Autopsy results showed an increase of osteoclasts in the bone marrow and metastatic calcification in multiple organs, and excluded from the differential diagnosis other disorders which present lymph-node swelling and hypercalcemia such as cancer, lymphoma, Castleman's disease, and sarcoidosis. He was given a diagnosis of IgG4ROD with osteolytic hypercalcemia.

Original languageEnglish
Pages (from-to)23-30
Number of pages8
JournalCEN Case Reports
Volume8
Issue number1
DOIs
Publication statusPublished - Feb 1 2019
Externally publishedYes

Fingerprint

Eye Diseases
Hypercalcemia
Renal Insufficiency
Immunoglobulin G
Lacrimal Apparatus
Giant Lymph Node Hyperplasia
Kidney
Parathyroid Hormone-Related Protein
Cholecalciferol
Osteoclasts
Sarcoidosis
Serum
Radionuclide Imaging
Autopsy
Lymphoma
Stomach
Differential Diagnosis
Lymph Nodes
Bone Marrow
Tomography

Keywords

  • Hypercalcemia
  • IgG4-related disease
  • Metastatic calcification

ASJC Scopus subject areas

  • Nephrology

Cite this

A case of fatal osteolytic hypercalcemia complicated with IgG4-related ophthalmic disease leading to renal failure. / Kawakita, Chieko; Kinomura, Masaru; Gon, Yoshie; Okita, Chika; Katayama, Katsuyoshi; Nishikawa, Mana; Shimada, Noriaki; Notohara, Kenji; Fukushima, Masaki; Asano, Kenichiro.

In: CEN Case Reports, Vol. 8, No. 1, 01.02.2019, p. 23-30.

Research output: Contribution to journalArticle

Kawakita, C, Kinomura, M, Gon, Y, Okita, C, Katayama, K, Nishikawa, M, Shimada, N, Notohara, K, Fukushima, M & Asano, K 2019, 'A case of fatal osteolytic hypercalcemia complicated with IgG4-related ophthalmic disease leading to renal failure', CEN Case Reports, vol. 8, no. 1, pp. 23-30. https://doi.org/10.1007/s13730-018-0358-6
Kawakita, Chieko ; Kinomura, Masaru ; Gon, Yoshie ; Okita, Chika ; Katayama, Katsuyoshi ; Nishikawa, Mana ; Shimada, Noriaki ; Notohara, Kenji ; Fukushima, Masaki ; Asano, Kenichiro. / A case of fatal osteolytic hypercalcemia complicated with IgG4-related ophthalmic disease leading to renal failure. In: CEN Case Reports. 2019 ; Vol. 8, No. 1. pp. 23-30.
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