{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:09:05Z","timestamp":1772168945737,"version":"3.50.1"},"reference-count":7,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2015,5,11]],"date-time":"2015-05-11T00:00:00Z","timestamp":1431302400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>Severe hypercalcemia is a rare metabolic disorder in pediatric medicine. This report describes a rare case of severe hypercalcemia and its clinical manifestations in a 2-year-old toddler. The radiological findings caused by hypercalcemia and osteolysis were emblematic of the osteolytic lesions. Hypercalcemia led to massive pulmonary alveolar calcification. The hypercalcemia was successfully treated with pamidronate, a bisphosphonate drug class. Further investigation resulted in a diagnosis of acute lymphoblastic leukemia (ALL). The patient is currently on chemotherapy and has a favorable prognosis. Although severe hypercalcemia alone is an unusual finding as the first sign for ALL, this should be considered, not to mention the radiological images resulted from calcium deposits.<\/ns4:p>","DOI":"10.12688\/f1000research.6393.1","type":"journal-article","created":{"date-parts":[[2015,5,11]],"date-time":"2015-05-11T07:20:06Z","timestamp":1431328806000},"page":"111","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Pulmonary Alveolar Calcification as a Result of Severe Hypercalcemia due to Acute Lymphoblatic Leukemia."],"prefix":"10.12688","volume":"4","author":[{"given":"Jose","family":"Colleti Junior","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eliana","family":"Carla Armelin Benites","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustavo","family":"Spadaccia dos Santos Fernandes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norberto","family":"Antonio Freddi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter","family":"Koga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Werther","family":"Brunow de Carvalho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2015,5,11]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"424-7","DOI":"10.1097\/MPH.0b013e3181a1c12b","article-title":"Hypercalcemia in acute lymphoblastic leukemia: an overview.","volume":"31","author":"A Trehan","year":"2009","journal-title":"J Pediatric Hematol Oncol."},{"key":"ref-2","first-page":"176-80","article-title":"Hypercalcaemia: Pathogenesis, Clinical Manifestations, Differential Diagnosis 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Izadyar","year":"2010","journal-title":"J Pediatr Hematol Oncol."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"219-29","DOI":"10.3109\/15513818509026896","article-title":"Massive metastatic pulmonary calcification in an infant with aleukemic monocytic leukemia.","volume":"4","author":"A Northcutt","year":"1985","journal-title":"Pediatr Pathol."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/4-111\/v1\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/4-111\/v1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/4-111\/v1\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,12,5]],"date-time":"2018-12-05T07:51:22Z","timestamp":1543996282000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/4-111\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,5,11]]},"references-count":7,"URL":"https:\/\/doi.org\/10.12688\/f1000research.6393.1","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.6859.r9334","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.6859.r8865","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.6859.r9334","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.6859.r8865","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,5,11]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/4-111\/v1#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.6859.r8865, Jerry Zimmerman, Center for Clinical and Translational Research, Seatlle Children's Hospital, Seattle, WA, USA, 02 Jun 2015, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/4-111\/v1#referee-response-8865","order":0,"name":"referee-response-8865","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Jose Colleti Junior<\/b>; \n<i>Posted: 21 Jun 2015<\/i>; The comments of Dr Zimmerman about this article are relevant and helpful.I will try to elucidate some questions as follows:The phosphate was really high at the initial presentation, contributing to the calcification of soft tissue;&nbsp;The patient did not have hypertension;&nbsp;The initial EKG was normal (we did not expect that);&nbsp;There was no evidence of family neoplasias;&nbsp;We considered other drugs, besides bisphosphonates, to treat the hypercalcemia. We decided on pamidronate because of the availability, and our personal experience;&nbsp;Although the thoracic CT imaging is striking, the patient did not present any clinical signal of respiratory disorder.&nbsp;The patient is still undergoing treatment and is doing well.","URL":"https:\/\/f1000research.com\/articles\/4-111\/v1#referee-comment-1426","order":1,"name":"referee-comment-1426","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.6859.r9334, Ana Paula Panzeri Carlotti, Division of Pediatric Critical Care, Department of Pediatrics, Ribeir\u00e3o Preto Medical School, University of S\u00e3o Paulo, Ribeir\u00e3o Preto, Brazil, 08 Jul 2015, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/4-111\/v1#referee-response-9334","order":2,"name":"referee-response-9334","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Data associated with the article are available under the terms of the Creative Commons Zero \"No rights reserved\" data waiver (CC0 1.0 Public domain dedication).","order":0,"name":"copyright-info","label":"Copyright"}]}}