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All-Trans-Retinoic-Acid Unmasking Hypercalcemia of Hyperparathyroidism

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Abstract

We present a patient of acute promyelocytic leukaemia managed with all-trans-retinoic-acid and arsenic trioxide who developed hypercalcemia with target organ damage. The patient also was simultaneously discovered to be symptomatic from hyperparathyroidism, which was unmasked after ATRA administration. Patient was successfully managed without any interruption of ATRA therapy and parathyroidectomy. We discuss the mechanisms of ATRA in causing hypercalcemia and its possible role in index case in unmasking hyperparathyroidism. Present case refutes Occam’s razor and emphasise that known adverse effects shouldn’t withhold clinicians from working up for other common causes for a given condition.

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Funding

This study was not funded by any institution or authority.

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Authors and Affiliations

  1. Department of Clinical Haematology, Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India

    Uday Yanamandra, Kamal Kant Sahu, Alka Khadwal, Gaurav Prakash, Subhash Chander Varma & Pankaj Malhotra

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  1. Uday Yanamandra
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  2. Kamal Kant Sahu
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  3. Alka Khadwal
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  4. Gaurav Prakash
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  5. Subhash Chander Varma
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  6. Pankaj Malhotra
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Correspondence to Pankaj Malhotra.

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This article does not contain any studies with animals performed by any of the authors. This article does not contain any studies with human participants or animals performed by any of the authors.

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Informed consent was obtained from the participant included in the study.

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Yanamandra, U., Sahu, K.K., Khadwal, A. et al. All-Trans-Retinoic-Acid Unmasking Hypercalcemia of Hyperparathyroidism. Indian J Hematol Blood Transfus 32 (Suppl 1), 41–45 (2016). https://doi.org/10.1007/s12288-015-0587-1

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  • DOI: https://doi.org/10.1007/s12288-015-0587-1

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