Parathyroid hormone-independent hypercalcemia in an infant with renal dysplasia: possible role of PTHrP.

ABSTRACT

BACKGROUND: Parathyroid hormone (PTH)-independent hypercalcemia in patients with chronic kidney failure is a rare and poor understood entity. CASE REPORT We report the case of an infant with stage III chronic kidney failure secondary to multicystic dysplastic kidney disease, who presented at 3 months of life with severe hypercalcemia, suppressed PTH, and elevated PTH-related peptide. Malignancy was discarded, and the patient was treated twice with bisphosphonates with an initial partial response. During follow-up, the calcium levels descended. To date, he has maintained normal serum calcium level for 1 year after discharge. CONCLUSIONS: The presence of PTH-related peptide may play a role in hypercalcemia associated to multicystic dysplastic kidney disease possibly by the overproduction of this peptide in the kidney.