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"etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Jorge" "apellidos" => "Martinez Sainz de Jubera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Nagore" "apellidos" => "García de Andoin Barandiaran" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "José Javier" "apellidos" => "Úriz Monaut" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "Sheila" "apellidos" => "López Cuesta" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Ana" "apellidos" => "Domínguez Castells" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Sección de Nefrología Pediátrica, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Oncología Pediátrica, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hipercalcemia e hipofosforemia en niña con tumour ovárico" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The most common cause of hypercalcaemia in patients with non-metastatic solid tumours is the secretion of parathyroid hormone-related (PTHr) protein.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The patient is an 11-year-old female with no history of interest, to be evaluated for an abdominal mass. Upon arrival the patient showed high serum creatinine, hypercalcaemia and hypophosphatemia (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). The baseline renal function test also showed hypercalciuria and hyperphosphaturia. CT scan showed a large intra-abdominal mass. A complete resection of the tumour was performed. An anatomopathological study revealed the presence of an ovarian granulosa cell tumour.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Clinical course was favourable. In the follow-up, one week after removal of the tumour, blood calcium levels normalised but urinary calcium remained high. The hypophosphataemia persisted, despite greater renal reabsorption of phosphate. After one month, all blood and urine biochemical parameters were within the normal range (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><p id="par0020" class="elsevierStylePara elsevierViewall">Hypercalcaemia due to hypersecretion of PTHr by malignant tumours is an exceptional finding at paediatric age.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">2,3</span></a> Parathyroid hormone (PTH) and PTHr have shown similar effects in the renal handling of calcium and phosphate.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">4–7</span></a> They release calcium from bone and promote the renal reabsorption of calcium in the distal nephron. They also produce hyperphosphaturia by decreasing the tubular reabsorption of phosphate that may result in hypophosphataemia. However, patients with hyperparathyroidism may present with hypercalciuria.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">8</span></a> The elevated calcaemia in our patient is related to high levels of PTHr. Significantly, hypercalciuria persisted after excision of the tumour and normalisation of calcaemia levels.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Another remarkable finding was the presence of hypophosphataemia, which became significant. The hypophosphataemia coincided with a situation of renal phosphate loss, evidenced by low levels of TRP and TP/GFR, indicating that the hypophosphataemia was of renal origin.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In conclusion, we present a case of PTHr-mediated hypercalcaemia secondary to an ovarian tumour in an age group that is rarely affected by this condition. In addition to transient renal failure, the biochemical data show hypercalcaemia accompanied by hypercalciuria. The hypophosphataemia is secondary to an excessive loss of phosphate through the kidney.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as: Ubetagoyena Arrieta M, Martinez Sainz de Jubera J, García de Andoin Barandiaran N, Úriz Monaut JJ, López Cuesta S, Domínguez Castells A. Hipercalcemia e hipofosforemia en niña con tumour ovárico. Nefrologia. 2017;37:100–101.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">CEI: calcium excretion index; PTHr: parathyroid hormone-related protein; TP/GFR: phosphate per 100<span class="elsevierStyleHsp" style=""></span>ml of glomerular filtration rate; TRP: tubular reabsorption of phosphate.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Pre-operative \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Six days after surgery \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Thirty days after surgery \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Sixty days after surgery \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Blood creatinine (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.64 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Blood-ionised calcium (mMol/l) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.22 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Blood phosphate (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.6<span class="elsevierStyleHsp" style=""></span>mgr/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.8<span class="elsevierStyleHsp" style=""></span>mgr/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PTH intact (pg/ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PTHr<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> (pmol/l) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><1.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Vitamin D (ng/ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Calcitonin (pg/ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Urine Ca/Cr ratio \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.09 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.07 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">CEI<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.59 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.34 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.06 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.05 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Calciuria (mg/kg/24<span class="elsevierStyleHsp" style=""></span>h) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7.43 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.61 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.26 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">TRP<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">32 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">96 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">94 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">90 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">TP/GFR<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.85 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.71 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.88 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.82 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Phosphaturia (mg/24<span class="elsevierStyleHsp" style=""></span>h/1.73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">954 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">110 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">427 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">880 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1375917.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005"><span class="elsevierStyleItalic">Source</span>: Santos and García-Nieto.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a></p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Biochemical blood and urine values prior to tumour removal and at days 6, 30 and 60 after surgery.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0050" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Serun parathyroid hormona-related protein concentrations in patients with hematologic malignancies or solid tumors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Y. 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Year/Month | Html | Total | |
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2024 October | 109 | 39 | 148 |
2024 September | 99 | 27 | 126 |
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2024 July | 82 | 35 | 117 |
2024 June | 100 | 44 | 144 |
2024 May | 112 | 42 | 154 |
2024 April | 88 | 28 | 116 |
2024 March | 70 | 28 | 98 |
2024 February | 72 | 39 | 111 |
2024 January | 64 | 23 | 87 |
2023 December | 53 | 35 | 88 |
2023 November | 88 | 38 | 126 |
2023 October | 57 | 27 | 84 |
2023 September | 67 | 28 | 95 |
2023 August | 72 | 21 | 93 |
2023 July | 75 | 27 | 102 |
2023 June | 86 | 23 | 109 |
2023 May | 99 | 28 | 127 |
2023 April | 43 | 18 | 61 |
2023 March | 66 | 23 | 89 |
2023 February | 46 | 18 | 64 |
2023 January | 69 | 30 | 99 |
2022 December | 77 | 34 | 111 |
2022 November | 74 | 26 | 100 |
2022 October | 80 | 46 | 126 |
2022 September | 72 | 35 | 107 |
2022 August | 70 | 42 | 112 |
2022 July | 64 | 48 | 112 |
2022 June | 54 | 33 | 87 |
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2022 April | 82 | 57 | 139 |
2022 March | 77 | 44 | 121 |
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2022 January | 66 | 36 | 102 |
2021 December | 110 | 46 | 156 |
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2021 October | 102 | 42 | 144 |
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2021 August | 68 | 43 | 111 |
2021 July | 75 | 33 | 108 |
2021 June | 87 | 39 | 126 |
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2021 April | 158 | 64 | 222 |
2021 March | 127 | 43 | 170 |
2021 February | 57 | 33 | 90 |
2021 January | 61 | 18 | 79 |
2020 December | 94 | 22 | 116 |
2020 November | 66 | 16 | 82 |
2020 October | 57 | 17 | 74 |
2020 September | 55 | 20 | 75 |
2020 August | 68 | 9 | 77 |
2020 July | 85 | 18 | 103 |
2020 June | 81 | 15 | 96 |
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2020 January | 78 | 17 | 95 |
2019 December | 58 | 18 | 76 |
2019 November | 57 | 21 | 78 |
2019 October | 60 | 9 | 69 |
2019 September | 76 | 22 | 98 |
2019 August | 52 | 19 | 71 |
2019 July | 54 | 18 | 72 |
2019 June | 62 | 14 | 76 |
2019 May | 44 | 18 | 62 |
2019 April | 75 | 27 | 102 |
2019 March | 58 | 22 | 80 |
2019 February | 35 | 16 | 51 |
2019 January | 27 | 28 | 55 |
2018 December | 139 | 47 | 186 |
2018 November | 248 | 30 | 278 |
2018 October | 241 | 17 | 258 |
2018 September | 111 | 20 | 131 |
2018 August | 51 | 13 | 64 |
2018 July | 57 | 15 | 72 |
2018 June | 78 | 18 | 96 |
2018 May | 69 | 11 | 80 |
2018 April | 131 | 12 | 143 |
2018 March | 103 | 9 | 112 |
2018 February | 89 | 10 | 99 |
2018 January | 69 | 8 | 77 |
2017 December | 88 | 6 | 94 |
2017 November | 61 | 13 | 74 |
2017 October | 34 | 10 | 44 |
2017 September | 32 | 3 | 35 |
2017 August | 50 | 10 | 60 |
2017 July | 59 | 4 | 63 |
2017 June | 48 | 6 | 54 |
2017 May | 52 | 12 | 64 |
2017 April | 38 | 6 | 44 |
2017 March | 42 | 4 | 46 |
2017 February | 6 | 1 | 7 |