Hypocalcemia in a Patient with Cancer

Rosner, Mitchell H.

doi:10.2215/cjn.13241216

Cited by 4 publications

(1 citation statement)

References 23 publications

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“…The biologic agent denosumab, a monoclonal antibody that inhibits RANK ligand, is an approved agent for the treatment of osteoporosis [6]. However, bone osteoclasts' resistance to PTH created through RANK ligand blockade can cause hypocalcemia [7, 8]. This leads to elevated PTH that continues to exert its effects on renal tubules, potentially lowering serum phosphorous.…”

Section: Introductionmentioning

confidence: 99%

Severe, Symptomatic Hypocalcemia due to Denosumab Administration: Treatment and Clinical Course

Strickling

Wilkowski

2019

Case Rep Nephrol Dial

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Denosumab is a receptor activator of nuclear factor kappa-B (RANK) ligand inhibitor used in the treatment of osteoporosis. Blockade of RANK ligand prevents osteoclastic resorption of bone, but in doing so impairs the parathyroid hormone (PTH)-driven maintenance of serum calcium. A subsequent elevation of PTH remains active at sites other than bone, potentially lowering serum phosphate by inhibiting proximal tubular reabsorption. We present 2 patients who developed severe, symptomatic hypocalcemia after administration of denosumab. These patients provide an opportunity to describe the clinical course and treatment, including the need to consider a continuous calcium infusion, of severe, symptomatic hypocalcemia caused by denosumab.

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Section: Introductionmentioning

confidence: 99%