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Hypercalcemia in metastatic GIST caused by systemic elevated calcitriol: a case report and review of the literature

Overview of attention for article published in BMC Cancer, October 2015
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Title
Hypercalcemia in metastatic GIST caused by systemic elevated calcitriol: a case report and review of the literature
Published in
BMC Cancer, October 2015
DOI 10.1186/s12885-015-1823-7
Pubmed ID
Authors

Katrine Hygum, Christian Nielsen Wulff, Torben Harsløf, Anders Kindberg Boysen, Philip Blach Rossen, Bente Lomholt Langdahl, Akmal Ahmed Safwat

Abstract

Hypercalcemia is the most common oncologic metabolic emergency but very rarely observed in patients with gastrointestinal stromal tumour, which is a rare mesenchymal malignancy of the gastrointestinal tract. We describe a case of hypercalcemia caused by elevated levels of activated vitamin D in a patient with gastrointestinal tumour. Prior to this case report, only one paper has reported an association between hypercalcemia, gastrointestinal stromal tumours and elevated levels of vitamin D. An otherwise healthy 70-year-old Caucasian woman, previously treated for duodenal gastrointestinal stromal tumour, was diagnosed with liver metastasis, and relapse of gastrointestinal stromal tumour was confirmed by biopsy. At presentation, the patient suffered from severe symptoms of hypercalcemia. The most common causes of hypercalcemia, hyperparathyrodism, parathyroid hormone-related peptide secretion from tumour cells, and metastatic bone disease, were all dismissed as the etiology. Analysis of vitamin D subtypes revealed normal levels of both 25-OH Vitamin D2 and 25-OH Vitamin D3, whereas the level of activated vitamin D, 1,25 OH Vitamin D3, also referred to as calcitriol, was elevated. The fact that plasma calcitriol decreased after initiation of oncological treatment and the finding that hypercalcemia did not recur during treatment support the conclusion that elevated calcitriol was a consequence of the gastrointestinal stromal tumour. We suggest that gastrointestinal stromal tumours should be added to the list of causes of humoral hypercalcemia in malignancy, and propose that gastrointestinal stromal tumour tissue may have high activity of the specific enzyme 1α-hydroxylase, which can lead to increased levels of calcitriol and secondarily hypercalcemia.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 23 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Brazil 1 4%
Unknown 22 96%

Demographic breakdown

Readers by professional status Count As %
Student > Master 7 30%
Student > Bachelor 3 13%
Student > Postgraduate 2 9%
Student > Ph. D. Student 2 9%
Lecturer 1 4%
Other 4 17%
Unknown 4 17%
Readers by discipline Count As %
Medicine and Dentistry 11 48%
Nursing and Health Professions 3 13%
Pharmacology, Toxicology and Pharmaceutical Science 2 9%
Unknown 7 30%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 October 2015.
All research outputs
#15,901,114
of 23,613,071 outputs
Outputs from BMC Cancer
#4,249
of 8,487 outputs
Outputs of similar age
#168,565
of 284,967 outputs
Outputs of similar age from BMC Cancer
#104
of 222 outputs
Altmetric has tracked 23,613,071 research outputs across all sources so far. This one is in the 22nd percentile – i.e., 22% of other outputs scored the same or lower than it.
So far Altmetric has tracked 8,487 research outputs from this source. They receive a mean Attention Score of 4.4. This one is in the 39th percentile – i.e., 39% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 284,967 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 32nd percentile – i.e., 32% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 222 others from the same source and published within six weeks on either side of this one. This one is in the 44th percentile – i.e., 44% of its contemporaries scored the same or lower than it.