000			03362nam a22004457a 4500
008			240807s20242024 xxu||||| |||| 00| 0 eng d
022			_a2000-9666
024			_ajchim-14-03-072 [pii]
024			_aPMC11259480 [pmc]
040			_aOvid MEDLINE(R)
099			_a39036577
245			_aEndocrine Shades of Silicone Fillers: A Case of Calcitriol-mediated Hypercalcemia.
251			_aJournal of Community Hospital Internal Medicine Perspectives. 14(3):72-76, 2024.
252			_aJ Community Hosp Intern Med Perspect. 14(3):72-76, 2024.
253			_aJournal of community hospital internal medicine perspectives
260			_c2024
260			_fFY2025
260			_p2024/07/22 05:35
265			_sepublish
265			_tPubMed-not-MEDLINE
266			_d2024-08-07
520			_aBackground: The inflammatory reaction of foreign body granulomas (FBG) may be so vast that it leads to severe systemic effects.
520			_aCase report: A 42-year-old woman was referred to the ED with severe recurrent symptomatic hypercalcemia associated with worsening kidney function. She had presented multiple times with similar complaints. Severe hypercalcemia (13.8 mg/dL) was noted, with appropriately low PTH, elevated PTHrP, low 25-hydroxyvitamin D, and normal 1,25-dihydroxyvitamin D levels. She admitted having significant subcutaneous silicone filler injections in the hips six years prior. Admission workup revealed a normal 25-hydroxyvitamin D, but a marked elevation of 1,25-dihydroxyvitamin D (138 pg/mL). Whole-body PET-CT demonstrated moderate 2-18F-fluoro-2-deoxy-d-glucose (FDG) uptake within the subcutaneous adipose tissue of the lateral aspects of the gluteal regions. She was diagnosed with silicone filler injection-induced hypercalcemia, secondary to granulomatous inflammation. Her calcium level normalized a month after the initiation of prednisone.
520			_aConclusion: Granulomatous inflammation from silicone filler injection can cause hypercalcemia by uncontrolled production of calcitriol and increased PTHrP production by macrophages and giant cells. Copyright © 2024 Greater Baltimore Medical Center.
520			_aDiscussion: FBG may occur years after filler injection. In rare cases, a significant granulomatous immune response leads to uncontrolled production of calcitriol. Pro-inflammatory cytokines can also upregulate PTHrP expression in macrophages, further contributing to hypercalcemia. Treatment focuses on general hypercalcemia management and FBG remission, most effectively achieved with anti-inflammatory corticosteroid doses. Nevertheless, further studies are needed to evaluate its long-term treatment efficacy.
546			_aEnglish
650			_zAutomated
651			_aMedStar Union Memorial Hospital
656			_aHospitalist
656			_aInternal Medicine Residency
657			_aCase Reports
657			_aJournal Article
700			_aAntoni, Fidini _bMUMH _cInternal Medicine Residency _dMD
700			_aHaas, Christopher _bMUMH
700			_aMadsen-Barbosa, Thayse L _bMUMH _cInternal Medicine Residency
700			_aMartinez-Cruz, Maria _bMUMH _cInternal Medicine Residency
790			_aMartinez-Cruz M, Madsen-Barbosa TL, Antoni F, Haas C
856			_uhttps://dx.doi.org/10.55729/2000-9666.1349 _zhttps://dx.doi.org/10.55729/2000-9666.1349
942			_cART _dArticle
999			_c14447 _d14447