Cinacalcet increases renal calcium excretion in PTHrP-mediated hypercalcemia: a case report.
Cinacalcet increases renal calcium excretion in PTHrP-mediated hypercalcemia: a case report.
复制标题
DOI：
10.1186/s12902-023-01386-3
复制
发表时间：
2023-06-16
影响因子：
2.7
通讯作者：
Ku, Gregory
中科院分区：
文献类型：
--
作者：
Faiq, Samya;Lavelle, Kristen;Hu, Tina;Shoback, Dolores;Ku, Gregory
在急性情况下，PTH非依赖性高钙血症通常用抗吸收剂如唑来膦酸或狄诺塞单抗治疗。当这些药物不再能够控制高钙血症时，一些病例报告显示西那卡塞的效用。然而，尚不清楚西那卡塞是否对抗吸收治疗初治患者有效，以及西那卡塞如何改善高钙血症。一位47岁男性，有酒精性肝硬化病史，因口腔浸润性鳞状细胞癌导致左颊出血和肿胀而入院。入院时，发现他的白蛋白校正血清钙升高13.6 mg/dL，血清磷2.2 mg/dL，PTH为6 pg/mL（正常18-90），PTHrP为8.1 pmol/L（正常< 4.3），符合PTHrP依赖性高钙血症。开始积极的静脉盐水水合和皮下鲑鱼降钙素，但他的血清钙仍然升高。考虑到第二天计划拔牙，并且在不久的将来可能对颌骨进行放射治疗，寻求抗吸收治疗的替代方案。西那卡塞的起始剂量为30 mg，每日两次，第二天增加至60 mg，每日两次。白蛋白校正的血清钙水平在48小时内从13.2 mg/dL降至10.9 mg/dL。钙排泄分数从3.7%增加到7.0%。该病例证明了西那卡塞通过增加肾脏钙清除率治疗PTHrP介导的高钙血症，而无需既往抗吸收治疗。
In the acute setting, PTH-independent hypercalcemia is typically treated with anti-resorptive agents such as zoledronic acid or denosumab. When these agents are no longer able to control hypercalcemia, several case reports have shown the utility of cinacalcet. However, it is not known if cinacalcet can be effective in patients naïve to anti-resorptive therapy or how cinacalcet ameliorates the hypercalcemia. A 47-year-old male with a history of alcohol-induced cirrhosis was admitted for left cheek bleeding and swelling from an infiltrative squamous cell carcinoma of the oral cavity. On admission, he was found to have an elevated albumin-corrected serum calcium of 13.6 mg/dL, a serum phosphorus of 2.2 mg/dL and an intact PTH of 6 pg/mL (normal 18–90) with a PTHrP of 8.1 pmol/L (normal < 4.3), consistent with PTHrP-dependent hypercalcemia. Aggressive intravenous saline hydration and subcutaneous salmon calcitonin were initiated, but his serum calcium remained elevated. Given tooth extractions scheduled for the next day and possible irradiation to the jaw in the near future, alternatives to antiresorptive therapy were sought. Cinacalcet was initiated at 30 mg twice daily then increased to 60 mg twice daily the following day. The albumin-corrected serum calcium level decreased from 13.2 to 10.9 mg/dL within 48 h. The fractional excretion of calcium increased from 3.7 to 7.0%. This case demonstrates the utility of cinacalcet for the treatment of PTHrP-mediated hypercalcemia without prior anti-resorptive therapy via increased renal clearance of calcium.
登录
查看更多内容
DOI：
10.1002/jbmr.3864
发表时间：
2020-01
期刊：
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
影响因子：
--
作者：
Cheng Z;Li A;Tu CL;Maria CS;Szeto N;Herberger A;Chen TH;Song F;Wang J;Liu X;Shoback DM;Chang W
通讯作者：
Chang W
影响因子：
4.8
作者：
Lorch, Gwendolen;Viatchenko-Karpinski, Serge;Rosol, Thomas J.
通讯作者：
Rosol, Thomas J.
影响因子：
4.7
作者：
Sheehan, Michael T.;Wermers, Robert A.;Onitilo, Adedayo A.
通讯作者：
Onitilo, Adedayo A.
影响因子：
2.9
作者：
O'Callaghan S;Yau H
通讯作者：
Yau H
影响因子：
0.8
作者：
Bech, Anneke;Smolders, Koen;de Boer, Hans
通讯作者：
de Boer, Hans