Author(s)

Damien Hansra^1*, Diaz Liege², Victoria Sujoy³, Ikpatt Offiong³, Chris Wunsch³, James E. Hoffman⁴

¹Oncology and Radiation Associates, Miami, USA.
²Department of Internal Medicine, University of Miami/Jackson Memorial Hospital, Miami, USA.
³Department of Pathology and Laboratory Medicine, University of Miami/Jackson Memorial Hospital, Miami, USA.
⁴Sylvester Comprehensive Cancer Center, Miami, USA.

IgG Heavy Chain Disease (γHCD) is a rare plasma cell disorder. Hypercalcemia related to plasma cell dyscrasias is related to non-PTHrP related mechanisms. Here we describe the first case of a patient with γHCD and PTHrP related hypercalcemia. Methods: Patient case derived from chart review from 2011 to 2015. Literature review performed searching PubMed 1968-current. Results: The patient was diagnosed with hypercalcemia with elevated PTHrP and exclusion of other etiologies of hypercalcemia. She was diagnosed with (γHCD) by M-spike 0.64 g/dL, IFE showing a broad band of IgG heavy chain, without associated light chains and severe depression of the non-mono-clonal IgG. Serum immunoglobulins demonstrated elevated IgG (2110 mg/dL), normal IgA (46 mg/dL) and decreased IgM (<21 mg/dL). Bone marrow biopsy showed 5% PCs, non-clonal by kappa/lambda, but exclusive for IgG by IHC, without any staining for IgA or IgM. The patient was started on therapy with improved hypercalcemia and PTHrP levels. Conclusions: This is the first reported case of γHCD presenting with PTHrP related hypercalcemia. Given that skeletal involvement is uncommon in γHCD, hypercalcemia secondary to γHCD may at times be a PTHrP driven phenomenon and we recommend that this test be ordered in such cases.

Hypercalcemia, Parathyroid Hormone-Related Peptide (PTHrP), Franklin Disease, Heavy Chain Myeloma

Hansra, D. , Liege, D. , Sujoy, V. , Offiong, I. , Wunsch, C. and Hoffman, J. (2015) Rare Case of a Patient Presenting with Parathyroid Hormone-Related Peptide Mediated Hypercalcemia and IgG Heavy Chain Disease: Case Report and Review of Literature. Open Journal of Blood Diseases, 5, 31-38. doi: 10.4236/ojbd.2015.53005.