Palliative treatment of uncontrollable hypercalcemia due to parathyrotoxicosis: denosumab as rescue therapy

Parathyroid carcinoma is a rare disease leading to severe hypercalcemia due to hyperparathyroidism. Surgery is the primary treatment option. A more progressive form of the disease is characterized by parathyrotoxicosis, and subsequent hypercalcemia is the most common cause of death. We report a case presenting with severe hypercalcemia due to parathyrotoxicosis from parathyroid carcinoma treated for the first time using the monoclonal antibody denosumab as a rescue therapy and present long-term follow-up data. The 71-year-old patient presented with severe hypercalcemia due to metastatic parathyroid carcinoma. Despite undergoing treatment with bisphosphonates, cinacalcet hydrochloride, and forced diuresis, the patient's condition deteriorated rapidly due to resistant hypercalcemia. Surgery performed because of spinal metastasis and forced diuresis lowered calcium levels, albeit they remained in the hypercalcemic range and significantly increased when forced diuresis was stopped. Considering a palliative situation to overcome hypercalcemia, we decided to administer denosumab, a monoclonal antibody that binds to the receptor activator of nuclear factor-kappa B ligand. After a single subcutaneous administration of 60 mg denosumab, calcium levels normalized within one day. Subsequent denosumab injections led to permanent control of serum calcium for more than 2 years despite rising parathyroid hormone levels and repeated surgeries. Together with recent cases in the literature supporting our observation, we believe that denosumab is relevant for future trials and represents an effective tool to control hypercalcemia in patients with advanced stages of parathyroid cancer

Volatile diterpene emission by two Mediterranean Cistaceae shrubs

Mediterranean vegetation emits a wide range of biogenic volatile organic compounds (BVOCs) among which isoprenoids present quantitatively the most important compound class. Here, we investigated the isoprenoid emission from two Mediterranean Cistaceae shrubs, Halimium halimifolium and Cistus ladanifer, under controlled and natural conditions, respectively. For the first time, diurnal emission patterns of the diterpene kaurene were detected in real-time by Proton-Transfer-Reaction-Timeof- Flight-Mass-Spectrometer. Kaurene emissions were strongly variable among H. halimifolium plants, ranging from 0.01 ± 0.003 to 0.06 ± 0.01 nmol m−2 s−1 in low and high emitting individuals, respectively. They were in the same order of magnitude as monoterpene (0.01 ± 0.01 to 0.11 ± 0.04 nmol m−2 s−1) and sesquiterpene (0.01 ± 0.01 to 0.52 nmol m−2 s−1) emission rates. Comparable range and variability was found for C. ladanifer under natural conditions. Labelling with 13C-pyruvate suggested that emitted kaurene was not derived from de novo biosynthesis. The high kaurene content in leaves, the weak relationship with ecophysiological parameters and the tendency of higher emissions with increasing temperatures in the field indicate an emission from storage pools. This study highlights significant emissions of kaurene from two Mediterranean shrub species, indicating that the release of diterpenes into the atmosphere should probably deserve more attention in the futureinfo:eu-repo/semantics/publishedVersio

Der Cytokiningehalt in Nadeln unterschiedlich stark von 'neuartigen Waldschaeden' betroffenen Fichten (Picea abies [L.] Karst.), bestimmt mittels einer immunoenzymatischen Methode - ELISA

Available from the library of Bonn Univ. (DE) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman

Satelliten - Cytokininmetabolismus in Picea abies und ipt-transgenem Populus

International audienc

Metabolism of isopentenyladenosine in the roots of Norway spruce seedlings exposed to nutritive stress

19 ref.Metabolism of isopentenyladenosine in the roots of Norway spruce seedlings exposed to nutritive stres

Isolation of two cytokinin metabolites from the rhizosphere of Norway spruce seedlings (Picea abies L. Karst)

24 ref.Isolation of two cytokinin metabolites from the rhizosphere of Norway spruce seedlings (Picea abies L. Karst

Metabolism of isopentenyladenosine in the roots of Norway spruce seedlings exposed to nutritive stress

Seedlings of Norway spruce (Picea abies) were grown on a low nutrient medium containing Al3+ ions (0.8 mM, stress) and a rich medium that was suitable for spruce and lacked Al3+ (control). After feeding with tritiated isopentenyladenosine via the roots, the metabolism of cytokinins in the roots of stressed and control plants was compared. HPLC radioactivity profiles of root extracts showed that isopentenyladenosine was mainly degraded to isopentenyladenine- and adenine/adenosine-like compounds. Stressed and non-stressed seedlings clearly differed with respect to the distribution of radioactivity for the different metabolites. The measurements showed that the degradation of isopentenyladenosine was strongly reduced in the roots of the stressed seedlings. Results are discussed with regard to the levels of endogenous cytokinins measured in spruce affected by the novel type of forest decline.Métabolisme de l'isopentényladénosine dans les racines d'épicéa soumis à un stress nutritif. De jeunes plantules d'épicéa (Picea abies) ont été plantés sur un milieu pauvre contenant des ions Al3+ (0,8 mM, stress) et sur un milieu sans Al3+ bien fourni en nutriments (témoin). Après marquage avec de l'isopentényladénosine tritiée, via les racines, le métabolisme des cytokinines dans les racines a été comparé chez les plants témoins et chez les plants stressés. Les profils de radioactivité, obtenus après HPLC, à partir des extraits racinaires, montrent que l'isopentényladénosine est principalement dégradé en isopentényladénosine et adénine ou adénosine. Les plantules stressées et non stressées diffèrent clairement dans leur distribution radioactive pour les différents métabolites. Les marquages montrent que la dégradation de l'isopentényladénosine est fortement retardée dans les racines des plantules stressées. Les résultats sont discutés en fonction des cytokinines endogènes chez l'épicéa, affecté par le nouveau type de dépérissement des forêts

Effects of the genetic transformation with the isopentenyltransferase gene on poplar

Effects of the genetic transformation with the isopentenyltransferase gene on popla

Effets de la transformation genetique avec le gene de l'isopentenyltransferase chez le peuplier

Effets de la transformation genetique avec le gene de l'isopentenyltransferase chez le peuplie

Enhancement of the endogenous cytokinin concentration in poplar by transformation with Agrobacterium T-DNA gene ipt

23 ref.Enhancement of the endogenous cytokinin concentration in poplar by transformation with Agrobacterium T-DNA gene ip