A case of denosumab-induced hypocalcaemia in a patient with non-metastatic prostate cancer and renal impairment.
A case of denosumab-induced hypocalcaemia in a patient with non-metastatic prostate cancer and renal impairment.
复制标题
患有非转移性前列腺癌且肾功能不全的患者出现狄诺塞麦引起的低钙血症的病例。
DOI：
10.4997/jrcpe.2015.209
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
J. Berg
中科院分区：
文献类型：
--
作者：
S. Blackley;K. Anderson;J. Berg
Denosumab是一种治疗绝经后女性和男性非转移性前列腺癌骨质疏松症的新兴新疗法。它主要被专家用作对传统更常用药物（如双膦酸盐）有禁忌症的患者的替代治疗。一个重要的副作用是低钙血症，这可能危及生命。肾损害患者发生这种情况的风险增加，主要是eGFR < 30 ml/min/1.73m（2），维生素D不足会加剧这种风险。这是一项在非转移性前列腺癌和中度肾损害（eGFR 40 ml/min/1.73m（2））患者中进行的地舒单抗单次给药后出现长期症状性低钙血症的病例研究。患者在治疗后5周出现急性意识模糊、肌肉痉挛和肌阵挛痉挛。该病例表明，需要了解地舒单抗在轻中度肾损害中的不良反应，以及需要监测治疗前后的钙水平。
Denosumab is an emerging new treatment for osteoporosis in postmenopausal women and men with non-metastatic prostate cancer. It is largely used by specialists as an alternative treatment in patients with contraindications to traditional, more commonly used drugs such as bisphosphonates. One important side effect is hypocalcaemia, which may be life threatening. The risk of this is increased in renal impairment, mainly if eGFR < 30 ml/min/1.73m(2), and is exacerbated by vitamin D insufficiency. This is a case study of prolonged symptomatic hypocalcaemia after a single dose of denosumab in a patient with non-metastatic prostate cancer and moderate renal impairment (eGFR 40 ml/min/1.73m(2)). The patient presented with acute confusion, muscle cramps and myoclonic jerks 5 weeks after treatment. This case demonstrates the need to be aware of adverse effects of denosumab in mild-moderate renal impairment and the need to monitor calcium levels pre- and post-treatment.