Severe hypercalcemia following denosumab treatment in a juvenile patient.

Abstract

A 10-year-old boy diagnosed with unresectable giant cell tumor of bone in the sacrum was treated with a bone modifying agent denosumab. Administration of denosumab showed excellent clinical response without any major complications, and the tumor was surgically removed afterwards. However, 4 months after discontinuing denosumab, the patient developed severe hypercalcemia (15.2 mg/dl). There was a sharp surge in the levels of bone resorption markers, indicating that disregulated overt bone resorption after the discontinuation of denosumab led to hypercalcemia. The patient was treated with bisphosphonate and barely recovered from the life-threatening conditions. This case shows that a robust rebound of bone resorption may occur following cessation of denosumab and suggests that hypercalcemia is an underappreciated side effect of denosumab therapy in children.

• Authors: Nokitaka Setsu, Eisuke Kobayashi, Naofumi Asano, Naoko Yasui, Hiroshi Kawamoto, Akira Kawai, Keisuke Horiuchi
• Journal: Journal of bone and mineral metabolism (J Bone Miner Metab) Vol. 34 Issue 1 Pg. 118-22 (Jan 2016) ISSN: 1435-5604 [Electronic] Japan
• PMID: 26056018 (Publication Type: Case Reports, Journal Article)

Chemical References

• Bone Density Conservation Agents
• Denosumab

Topics

• Bone Density Conservation Agents (adverse effects, therapeutic use)
• Bone Neoplasms (drug therapy)
• Bone Resorption (chemically induced)
• Child
• Denosumab (adverse effects, therapeutic use)
• Humans
• Hypercalcemia (chemically induced)
• Male