This is a very interesting article on a topic I have not seen before. It caught my attention as I recall some on the forum reporting Myasthenia Gravis along with the MPN. I have experience intermittent hypercalcemia, but I do not believe this is due to a Paraneoplastic Syndrome.
I did a comprehensive assessment with an endocrinologist regarding the intermittent hypercalcemia. Thyroid function and other potential causes were ruled out. Final conclusion is that the occasional calcium blips are a function of the breakdown of excess blood cells.
My rogue Parathyroid was confirmed after a Sestamibi/radioactive iodine CT scan. I also had lots of other tests leading up to the CT, which included 24 hour urine collection - that was fun! Getting 24 hours worth to my GP Surgery for hospital delivery! Bloods (again) and again and imagining of my kidneys. I've had no Hypercalcemia since, and my Haem makes a point of checking levels every few months.
Did you feel unwell during the times of your 'calcium blips'? I vividly remember feeling really out of sorts before diagnosis - My major symptoms were depression/forgetfulness and increased urination. I didn't go to see my GP during that time about them and Hypercalcemia was picked up during my routine PV blood tests.
I did not feel a thing when I had the calcium spikes. I also did the 24-hour metanephrine study. Thankfully, no issues there - no pheochromocytoma present. The intermittent hypercalcemia is just an anomaly that we keep an eye on. It has not recurred since I am in a complete hematological response, which supports the idea it is a direct function of the excess blood cells.
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