{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:30:06Z","timestamp":1762867806170,"version":"3.44.0"},"reference-count":25,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,5,21]]},"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:p>Hypercalcaemia is a rare but potentially life-threatening consequence of malignancies. Solid cancers, such as lymphomas, increase serum calcium primarily through parathyroid hormone-related protein or ectopic production of 1alpha-hydroxylase. We present a case of 56-year-old woman with Sjogren\u2019s syndrome and psoriasis in the setting of chronic methotrexate (MTX) use who developed worsening hypercalcaemia and symptoms suggestive of lymphoma. Pathology results diagnosed her with MTX-induced iatrogenic immunodeficiency-associated lymphoproliferative disorder (LPD). This case reminds clinicians that chronic MTX use is associated with LPDs and can ultimately lead to hypercalcaemia. The patient\u2019s MTX and other immunosuppressive medications were stopped, and her calcium corrected with fluids and calcitonin. At her 8-month follow-up postdischarge, the patient was asymptomatic with normal laboratory results and in partial clinical remission.<\/jats:p>","DOI":"10.1136\/bcr-2018-226633","type":"journal-article","created":{"date-parts":[[2019,6,1]],"date-time":"2019-06-01T07:45:11Z","timestamp":1559375111000},"page":"e226633","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Methotrexate-induced iatrogenic immunodeficiency-associated lymphoproliferative disorder causing hypercalcaemia"],"prefix":"10.1136","volume":"12","author":[{"given":"Monica","family":"Lee","sequence":"first","affiliation":[{"name":"Internal Medicine, Irvine School of Medicine, University of California, Irvine, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khoa Anh","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Internal Medicine, Irvine School of Medicine, University of California, Irvine, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Internal Medicine, Irvine School of Medicine, University of California, Irvine, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,5,31]]},"reference":[{"key":"2025082712594989000_12.5.e226633.1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.20.2337"},{"key":"2025082712594989000_12.5.e226633.2","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/s13045-017-0464-5","article-title":"Characterization and risk estimate of cancer in patients with primary Sj\u00f6gren syndrome","volume":"10","author":"Brito-Zer\u00f3n","year":"2017","journal-title":"J Hematol Oncol"},{"key":"2025082712594989000_12.5.e226633.3","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13192"},{"key":"2025082712594989000_12.5.e226633.4","doi-asserted-by":"publisher","DOI":"10.1080\/08860220500531005"},{"key":"2025082712594989000_12.5.e226633.5","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.12116"},{"key":"2025082712594989000_12.5.e226633.6","doi-asserted-by":"crossref","first-page":"3045","DOI":"10.3109\/10428194.2015.1022769","article-title":"Methotrexate-associated lymphoproliferative disorders: management by watchful waiting and observation of early lymphocyte recovery after methotrexate withdrawal","volume":"56","author":"Inui","year":"2015","journal-title":"Leuk Lymphoma"},{"key":"2025082712594989000_12.5.e226633.7","first-page":"2454","article-title":"[A case of iatrogenic immunodeficiency-associated lymphoproliferative disease in a patient treated with methotrexate for rheumatoid arthritis for 9 consecutive years, which Showed natural remission after discontinuation of MTX therapy]","volume":"40","author":"Kaneko","year":"2013","journal-title":"Gan To Kagaku Ryoho"},{"key":"2025082712594989000_12.5.e226633.8","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2011.625101"},{"key":"2025082712594989000_12.5.e226633.9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199305063281806"},{"key":"2025082712594989000_12.5.e226633.10","doi-asserted-by":"crossref","first-page":"1943","DOI":"10.1200\/JCO.1996.14.6.1943","article-title":"Spontaneous regression of lymphoproliferative disorders in patients treated with methotrexate for rheumatoid arthritis and other rheumatic diseases","volume":"14","author":"Salloum","year":"1996","journal-title":"J Clin Oncol"},{"key":"2025082712594989000_12.5.e226633.11","unstructured":"Upi MT . 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