Teriparatide Induced Delayed Persistent Hypercalcemia

Thiruchelvam, Nirosshan; Randhawa, Jaskirat; Sadiek, Happy; Kistangari, Gaurav

doi:10.1155/2014/802473

Cited by 12 publications

(11 citation statements)

References 8 publications

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“…Observations related to transitory hypercalcemia: In our cohort, 16.6% of patients were registered with temporary increase of blood calcium in a drug-related manner, a rate that confirms data from literature [12][13][14][15]. In neither of cases with transitor y hypercalcemia TPT was not necessary to be stopped.…”

Section: Resultssupporting

confidence: 88%

“…In the meantime the calcium evaluation is useful but some transitory self-limited cases of hypercalcemia may not be detected if a specific calendar of serum calcium assessment is not similarly performed in each case. Moreover, the timing of blood calcium assay is important since most of TPT-related hypercalcemia cases are described within first 16 hours of administration [12][13][14][15]. In our study all included patients were confirmed with hypercalcemia for at least two different assays in two different days.…”

Section: Resultsmentioning

confidence: 99%

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Clinical Data on Transitory Teriparatide-related Hypercalcemia in Daily Practice Treatment for Severe Menopausal Osteoporosis

Bechir¹,

Ţuculină²,

Cârșote³

et al. 2019

Rev. Chim.

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Teriparatide (TPT) (C181H291N55O51S2) represents a recombinant molecule acting as human osteoanabolic agent. Transitory hypercalcemia (TH) has been reported in osteoporotic patients treated with daily TPT. Our purpose is to analyze the biochemical features as well as clinical risk factors for fractures in patients with severe osteoporosis treated with TPT who developed TH during first 12 months. This is an observational real-life study. In patients with TH biochemical blood markers like osteocalcin, CrossLaps and P1NP assessed at one year have statistically significant higher values than in subjects associating serum calcium within normal limits under the drug.

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Section: Resultssupporting

confidence: 88%

Section: Resultsmentioning

confidence: 99%

Clinical Data on Transitory Teriparatide-related Hypercalcemia in Daily Practice Treatment for Severe Menopausal Osteoporosis

Bechir¹,

Ţuculină²,

Cârșote³

et al. 2019

Rev. Chim.

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“… 12 Those admitted were treated with intravenous fluids, diuretics and/or intravenous bisphosphonates. 13 – 16 Sustained hypercalcemia persisting for a week after teriparatide discontinuation has been reported as well. 14 In three patients, PTH was measured during the hypercalcemic episode.…”

Section: Discussionmentioning

confidence: 92%

Teriparatide-Associated Late Hypercalcemia: A Report of Two Cases and Literature Review

Milosavljevic¹,

Thomas²

2022

Journal of Community Hospital Internal Medicine Perspectives

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Introduction Teriparatide, recombinant human parathyroid hormone (1–34), is a safe and usually well-tolerated medication. We describe two cases of late-onset hypercalcemia associated with teriparatide use and report current evidence of hypercalcemia during the treatment with PTH analogs. Case report Case 1 is a 54-year-old man with a history of osteoporosis, previously treated with 6 months of teriparatide, but had not been consistent in taking the medication. Before restarting teriparatide, his serum calcium, PTH and vitamin D were normal. Six months into the treatment, he developed asymptomatic hypercalcemia of 11.2 mg/dL 24 h after the last dose. Repeat serum calcium was normal and treatment was continued. Case 2 is a 75-year old woman with a history of osteopenia and severe scoliosis. Before starting teriparatide, her calcium, PTH and vitamin D were normal. Six months into the treatment, she developed asymptomatic hypercalcemia of 12.5 mg/dL. Teriparatide was held and subsequently her serum calcium normalized. Discussion Transient hypercalcemia can occur during treatment with teriparatide and usually resolves within 16 h after administration. Late hypercalcemia, occurring more than 24 h after the dose, is rarely seen. It is usually mild, asymptomatic and rarely occurs repeatedly. Hypercalcemia occurs more often in patients with pre-existing hypercalcemia or vitamin D deficiency. It is rarely a cause of treatment disruption (0.18–4%). Conclusion Clinicians should be aware of this side effect, especially in patients who may be at risk of complications of hypercalcemia.

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“…On the lymphoma spectrum, those with non-Hodgkin's lymphoma [3–5], chronic myeloid leukemia (blast phase) [6], and adult T-cell leukemia-lymphoma may have PTHrP-induced hypercalcemia [7, 8]. Teriparatide administration was unlikely because the effects of hypercalcemia are transient, usually resolving sixteen hours after the last administration [9]. Milk-alkali syndrome was unlikely given that she reported the consumption of only six tablets over a span of a month.…”

Section: Differential Diagnosismentioning

confidence: 99%