We read Dr Clark's remarks with great interest. The main point discussed is the hypophosphatemia found in the case reported. Although the fact that breast neoplasms secrete substances that do not cause hypophosphatemia is well documented, the case of a patient with low phosphorus level has been reported.1 Moreover, elevated levels of ectopic parathyroid hormone were found in 14 patients with breast cancer.2 Unfortunately, we did not determine the serum parathyroid hormone concentration because of technical reasons.
We agree with Dr Clark that administration of steroids may be a possible cause of the patient's acute pancreatitis, although it seems less likely.
Gafter U. Pancreatitis, Hypercalcemia, and Breast Carcinoma-Reply. JAMA. 1976;236(18):2052. doi:10.1001/jama.1976.03270190014011
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