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.
Kinderklinik and Kinderpoliklinik, Dr. von Haunersches Kinderspital, University of Munich, Germany. Irene.Schmid@kk-i.med.uni-muenchen.de
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Stachel
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Schön
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Bauer
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Haas
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