In humoral hypercalcemia of malignancy (HHM), what is the most common overproduced substance leading to hypercalcemia?
(1) Parathyroid hormone (PTH)
(2) Parathyroid hormone-related protein (PTHrP)
(3) 1,25-dihydroxyvitamin D (1,25(OH)2D)
(4) Calcitonin
📝 Explanation:
PTHrP is a protein that is structurally similar to parathyroid hormone (PTH) but is produced by some tumor cells. It acts on the PTH receptor, leading to increased calcium levels in the blood, similar to PTH. HHM is most often associated with overproduction of PTHrP by tumors, causing hypercalcemia without the typical elevation in PTH levels seen in primary hyperparathyroidism.