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Mithramycin Treatment of Intractable Hypercalcemia Due to Parathyroid Carcinoma

List of authors.
  • Frederick R. Singer, M.D.,
  • Robert M. Neer, M.D.,
  • Timothy M. Murray, M.D.,
  • Henry T. Keutmann, M.D.,
  • Leonard J. Deftos, M.D.,
  • and John T. Potts, Jr., M.D.

MITHRAMYCIN, a cytotoxic antibiotic used mainly in the therapy of embryonal tumors of the testis,1 2 3 4 5 has been stated to lower serum calcium levels even in normocalcemic patients.2 , 6 , 7 Its toxic side effects, particularly excessive bleeding, have restricted its reported use to patients with various cancers,1 2 3 4 5 6 , 8 9 10 11 12 13 14 one patient with hyperparathyroidism14 and short-term studies in two patients with Paget's disease of bone.7 We recently administered this drug† to a patient with metastatic parathyroid carcinoma and severe osteitis fibrosa cystica whose hypercalcemia, bone pain and related symptoms could not be controlled by surgical or intensive medical therapy. The drug acutely lowered plasma calcium to . . .

Funding and Disclosures

* From the Department of Medicine, Harvard Medical School and the Massachusetts General Hospital (address reprint requests to Dr. Singer at the Endocrine Unit, Massachusetts General Hospital, Boston, Mass. 02114).

Supported in part by grants (AM 05072, AM 04501 and AM 11794) from the U.S. Public Health Service (Dr. Murray is a fellow of the Medical Research Council of Canada).

† In the form of Mithracin, Chas. Pfizer and Co., Inc., New York, N.Y.

We are indebted to Drs. Stephen Krane and William Baker for calling to our attention the possible therapeutic benefit of mithramycin in this patient and to Drs. Alan Aisenberg and B. J. Kennedy for their helpful discussions in relation to the use and toxicity of the drug.

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