Pamidronate and calcitonin as therapy of acute cancer-related hypercalcemia in children.
Severe symptomatic hypercalcemia is a rare event in children with malignancies. Up to now there is limited experience treating childhood hypercalcemia with bisphosphonates in addition to calcitonin. We report a 5-year-old boy with acute lymphoblastic lymphoma who presented with malignant hypercalcemia at diagnosis. The maximal serum calcium concentration was 15.2 mg/dl (3.81 mmol/l). Conventional therapy with forced diuresis and furosemide failed. Calcitonin (10 IU/kg/24 h i.v. for 2 days) and pamidronate (1 mg/kg over 2 hours i.v.) were used successfully without adverse effect lowering the serum calcium level within 24 hours to normal values. We recommend the use of calcitonin and pamidronate as first-line therapy together with forced diuresis and furosemide in childhood hypercalcemia secondary to malignancies as it is rapidly effective and has no significant side effects.
Schmid
I
I
Kinderklinik and Kinderpoliklinik, Dr. von Haunersches Kinderspital, University of Munich, Germany. Irene.Schmid@kk-i.med.uni-muenchen.de
Stachel
D
D
Schön
C
C
Bauer
M
M
Haas
R J
RJ
D000469:Alkaline Phosphatase / Q000097:blood; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002116:Calcitonin / Q000008:administration & dosage / Q000627:therapeutic use*; D002118:Calcium / Q000097:blood; D002648:Child; D004164:Diphosphonates / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000209:etiology; D000077268:Pamidronate; D010710:Phosphates / Q000097:blood; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications*; D011859:Radiography; D013131:Spine / Q000000981:diagnostic imaging; D013997:Time Factors
D000970:Antineoplastic Agents; D004164:Diphosphonates; D010710:Phosphates; D002116:Calcitonin; D000469:Alkaline Phosphatase; D000077268:Pamidronate; D002118:Calcium