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Hypercalcemia is a frequent complication of multiple myeloma and has been observed in 43% of the 76 patients admitted to the Clinical Center of the National Institutes of Health from 1953 to 1961 (2). The pathogenesis of the hypercalcemia associated with multiple myeloma has been attributed to excessive bone resorption (3). Carbohydrate-active steroids have been successfully used to correct hypercalcemia associated with sarcoidosis (4), idiopathic hypercalcemia of infancy (5), and neoplastic diseases including multiple myeloma (6). In idiopathic hypercalcemia of infancy and sarcoidosis, diseases in which calcium absorption is increased, cortisone has been shown to increase total fecal calcium (4, 5). Steroids may also alter calcium metabolism of bone (7) and modify calcium transport in the renal tubule (8). In a single patient with multiple myeloma and hypercalcemia, corticosteroid administration was associated with net calcium retention and decreased bone resorption (3). The present study was designed to further study the effects of prednisone 1 on calcium metabolism in patients with multiple myeloma and hypercalcemia. Steroid-induced reversal of hypercalcemia is associated with a decrease in the miscible pool size and a distinct reduction in bone resorption.

The Effect of Prednisone on Calcium Metabolism and Ca47 Kinetics in Patients with Multiple Myeloma and Hypercalcemia *