Adult T-Cell Leukemia-Lymphoma during Pregnancy

Table 1

Pertinent laboratory findings.

	Result	Normal
Calcium	18.4 mg/dL	(8.3–10.2)
Ionized calcium	11.4 mg/dL	(3.0–6.5)
Phosphate	2.6 mg/dL	(2.3–4.5)
Parathyroid hormone (PTH)	<2.5 pg/mL	(10–65)
PTH-related protein (PTH-rp)	46 pg/mL	(14–27)
Vitamin D Total 25(OH)	39 ng/mL	(30–100)
Creatinine	1.06 mg/dL	(0.6–1.2)
Uric acid	12.2 mg/dL	(2.6–8.1)
Angiotensin-converting enzyme (ACE)	54	(9–67)
Serum protein electrophoresis (SPEP)	Negative
Urine protein electrophoresis (UPEP)	Negative
Serum pH	7.38	(7.35–7.45)

Elevated calcium with normal phosphate and PTH levels points against a diagnosis of primary hyperparathyroidism. Normal vitamin D and ACE levels point against a diagnosis of sarcoidosis or granulomatous disease. Creatinine was normal. Uric acid was noted to be elevated. Negative SPEP and UPEP point against a diagnosis of multiple myelomas. A normal serum pH points against a diagnosis of milk-alkali syndrome. Elevated PTH-rp levels are highly suggestive of hypercalcemia of malignancy.