{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:23:55Z","timestamp":1760189035744},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"828","license":[{"start":{"date-parts":[[1994,10,1]],"date-time":"1994-10-01T00:00:00Z","timestamp":780969600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1994,10,1]]},"DOI":"10.1136\/pgmj.70.828.764-b","type":"journal-article","created":{"date-parts":[[2008,12,29]],"date-time":"2008-12-29T21:25:21Z","timestamp":1230585921000},"page":"764-765","source":"Crossref","is-referenced-by-count":1,"title":["Selenium deficiency, reversible cardiomyopathy and short-term intravenous feeding"],"prefix":"10.1093","volume":"70","author":[{"given":"A J","family":"Larner","sequence":"first","affiliation":[{"name":"Department of Anatomy, University of Cambridge , Downing Street, Cambridge CB2 3DY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1994,10,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1136\/pgmj.70.820.113","article-title":"Indian herbal remedies for diabetes as a cause of lead poisoning","volume":"70","author":"Keen, R.W.; Deacon, A.C.; Delves, H.T.; Moreton, J.A.; Frost, P.G.","year":"1994","unstructured":"Keen, R.W., Deacon, A.C., Delves, H.T., Moreton, J.A. & Frost, P.G. Indian herbal remedies for diabetes as a cause of lead poisoning. Postgrad Med J 1994, 70: 113-114.","journal-title":"Postgrad Med J"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1177\/014107689108401028","article-title":"Lead poisoning due to Asian ethnic treatment for impotence","volume":"84","author":"Dolan, G.; Jones, A.P.; Reilly, J.; Bram, M.J.","year":"1991","unstructured":"Dolan, G., Jones, A.P., Reilly, J. & Bram, M.J. Lead poisoning due to Asian ethnic treatment for impotence. J R Soc Med 1991, 84: 630-631.","journal-title":"J R Soc Med"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1002\/ajim.4700200611","article-title":"A case of mistaken identity: herbal medicine as a cause of lead toxicity","volume":"20","author":"Smitherman, J.; Harber, P.","year":"1991","unstructured":"Smitherman, J. & Harber, P. A case of mistaken identity: herbal medicine as a cause of lead toxicity. Am J Indust Med 1991, 20: 795-798.","journal-title":"Am J Indust Med"},{"key":"ref_4","first-page":"915","article-title":"Lead encephalopathy due to herbal medicine","volume":"100","author":"Yu, C.L.; Yeung, C.Y.","year":"1987","unstructured":"Yu, C.L. & Yeung, C.Y. Lead encephalopathy due to herbal medicine. Chinese Med J 1987, 100: 915-917.","journal-title":"Chinese Med J"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1136\/bmj.308.6930.673","article-title":"Towards safer use of traditional remedies","volume":"308","author":"Atherton, D.","year":"1994","unstructured":"Atherton, D. Towards safer use of traditional remedies. Br Med J 1994, 308: 673-674.","journal-title":"Br Med J"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1136\/pgmj.70.821.235","article-title":"Selenium deficiency, reversible cardiomyopathy and short term intravenous feeding","volume":"70","author":"Levy, J.B.; Jones, H.W.; Gordon, A.C.","year":"1994","unstructured":"Levy, J.B., Jones, H.W. & Gordon, A.C. Selenium deficiency, reversible cardiomyopathy and short term intravenous feeding. Postgrad Med J 1994, 70: 235-236.","journal-title":"Postgrad Med J"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/S0016-5085(72)80032-5","article-title":"Paresthesias, weakness, seizures and hypophosphatemia in patients receiving hyperalimentation","volume":"62","author":"Silvis, S.E.; Paragas, Jr, P.D.","year":"1972","unstructured":"Silvis, S.E. & Paragas, P.D., Jr. Paresthesias, weakness, seizures and hypophosphatemia in patients receiving hyperalimentation. Gastroenterology 1972, 62: 513-520.","journal-title":"Gastroenterology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1056\/NEJM197710272971702","article-title":"Effect of hypophosphatemia on myocardial performance in man","volume":"297","author":"O'Connor, L.R.; Wheeler, W.S.; Bethune, J.E.","year":"1977","unstructured":"O'Connor, L.R., Wheeler, W.S. & Bethune, J.E. Effect of hypophosphatemia on myocardial performance in man. N Engl J Med 1977, 297: 901-903.","journal-title":"N Engl J Med"},{"key":"ref_9","first-page":"734","article-title":"Treatment of severe hypophosphataemia","volume":"ii:","author":"Editorial","year":"1981","unstructured":"Editorial. Treatment of severe hypophosphataemia. Lancet 1981, ii: 734.","journal-title":"Lancet"},{"key":"ref_10","first-page":"203","article-title":"The pathophysiology and clinical characteristics of severe hypophosphatemia","volume":"137","author":"Knochel, J.P.","year":"1977","unstructured":"Knochel, J.P. The pathophysiology and clinical characteristics of severe hypophosphatemia. Arch Intern Med 1977, 137: 203-220. Sir, Occult malignancy may present as hypercalcaemia and increased levels of parathyroid hormone-related protein (PTHrp), as recently reported in the Journal by Hutchesson et al.' Only six patients with oesophageal carcinoma presenting as hypercalcaemia have been reported. Only one patient had no local obstructing symptoms or bone metastasis, and serum parathyroid hormone was found to be mildly elevated.2 We report a patient with squamous cell carcinoma of the oesophagus (SCCE) and no obstructing symptoms, presenting as malignant hypercalcaemia, with intact parathyroid hormone (iPTH) suppressed, and increased PTHrp.","journal-title":"Arch Intern Med; Sir, Occult malignancy may present as hypercalcaemia and increased levels of parathyroid hormone-related protein (PTHrp), as recently reported in the Journal by Hutchesson et al.' Only six patients with oesophageal carcinoma presenting as hypercalcaemia have been reported. Only one patient had no local obstructing symptoms or bone metastasis, and serum parathyroid hormone was found to be mildly elevated.2 We report a patient with squamous cell carcinoma of the oesophagus (SCCE) and no obstructing symptoms, presenting as malignant hypercalcaemia, with intact parathyroid hormone (iPTH) suppressed, and increased PTHrp"},{"key":"ref_11","article-title":"A 56 year old man was admitted in June 1991 for acute hypercalcaemia. He had had surgery for duodenal ulcer and cholelithiasis in 1988 and 1989, when serum calcium was 2.1 mmol\/l (normal range (NR) 2.1-2.6), and albumin 40 g\/l. In the 15 days prior to admission asthenia, anorexia, weight loss, polyuria, polydypsia and altered level of consciousness progressively developed. Investigations disclosed metabolic alkalosis, total serum calcium, 3.69 mmol\/l, total serum proteins 75 g\/l, phosphorus 0.8 mmol\/l. The serum iPTH was <0.3 pmol\/l (NR 37-80). Serum PTHrp was determined by competitive radioimmunoanalysis using specific antibody against fragment 1-40 of human PTHrp, INCSTAR, USA and was 11.2 (range in normocalcaemic controls 0.99-7.39). Skeletal X-ray films were normal. Despite rehydration, total serum calcium reached 4.65 mmol\/l. Calcitonin, steroids and intravenous biphosphonates were initiated, but no response was observed","unstructured":"A 56 year old man was admitted in June 1991 for acute hypercalcaemia. He had had surgery for duodenal ulcer and cholelithiasis in 1988 and 1989, when serum calcium was 2.1 mmol\/l (normal range (NR) 2.1-2.6), and albumin 40 g\/l. In the 15 days prior to admission asthenia, anorexia, weight loss, polyuria, polydypsia and altered level of consciousness progressively developed. Investigations disclosed metabolic alkalosis, total serum calcium, 3.69 mmol\/l, total serum proteins 75 g\/l, phosphorus 0.8 mmol\/l. The serum iPTH was <0.3 pmol\/l (NR 37-80). Serum PTHrp was determined by competitive radioimmunoanalysis using specific antibody against fragment 1-40 of human PTHrp, INCSTAR, USA and was 11.2 (range in normocalcaemic controls 0.99-7.39). Skeletal X-ray films were normal. Despite rehydration, total serum calcium reached 4.65 mmol\/l. Calcitonin, steroids and intravenous biphosphonates were initiated, but no response was observed."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1136\/pgmj.69.814.640","article-title":"Parathyroid hormone-related protein as a tumour marker in humoral hypercalcaemia associated with occult malignancy","volume":"69","author":"Hutchesson, A.C.J.; Dunne, F.; Bundred, N.J.; Gee, H.; Ratcliffe, W.A.","year":"1993","unstructured":"Hutchesson, A.C.J., Dunne, F., Bundred, N.J., Gee, H. & Ratcliffe, W.A. Parathyroid hormone-related protein as a tumour marker in humoral hypercalcaemia associated with occult malignancy. Postgrad Med J 1993, 69: 640-642.","journal-title":"Postgrad Med J"},{"key":"ref_13","first-page":"621","article-title":"Unusual presentation of carcinoma of the esophagus","volume":"85","author":"Vaswani, S.; Dhodhapkar, M.","year":"1990","unstructured":"Vaswani, S. & Dhodhapkar, M. Unusual presentation of carcinoma of the esophagus. Am J Gastroenterol 1990, 85: 621.","journal-title":"Am J Gastroenterol"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2625","DOI":"10.1002\/1097-0142(19911215)68:12<2625::AID-CNCR2820681219>3.0.CO;2-T","article-title":"Hypercalcemia in patients with esophageal carcinoma. The pathophysiologic role of parathyroid hormone-related protein","volume":"68","author":"Trachimori, Y.; Watanabe, H.; Kato, H.","year":"1991","unstructured":"Trachimori, Y., Watanabe, H., Kato, H. et al. Hypercalcemia in patients with esophageal carcinoma. The pathophysiologic role of parathyroid hormone-related protein. Cancer 1991, 68: 2625-2629.","journal-title":"Cancer"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1097\/00000421-199012000-00016","article-title":"Spontaneous pneumomediastinum in esophageal carcinoma","volume":"16","author":"Sridhar, K.S.; Hussein, A.M.; Patten, J.E.","year":"1990","unstructured":"Sridhar, K.S., Hussein, A.M. & Patten, J.E. Spontaneous pneumomediastinum in esophageal carcinoma. 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