Hypercalcemia induced by 13-cis-retinoic acid in a patient with neuroblastoma.
Hypercalcemia is a potential dosage-related adverse effect of 13-cis-retinoic acid in patients with neuroblastoma. Severe hypercalcemia requiring dosage reduction has been reported in children receiving 13-cis-retinoic acid 200 mg/m2/day and in those with concurrent renal impairment receiving 160 mg/m2/day. A 12-year-old girl without renal dysfunction, diagnosed with neuroblastoma, developed severe hypercalcemia requiring several hospitalizations while receiving 13-cis-retinoic acid 160 mg/m2/day. Her hypercalcemia resolved with hydration, diuretic therapy, and temporary discontinuation of 13-cis-retinoic acid. Despite a 50% dosage reduction to 80 mg/m2/day, severe hypercalcemia recurred with the next treatment cycle. Further treatment with 13-cis-retinoic acid was made tolerable by shortening the duration of the remaining cycles. Serum calcium levels should be monitored in patients with neuroblastoma who receive 13-cis-retinoic acid.
Belden
Tara L
TL
Department of Pharmacy, Duke University Health System, Durham, North Carolina, USA.
Ragucci
Dominic P
DP
D001932:Brain Neoplasms / Q000150:complications*; D002648:Child; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000139:chemically induced*; D015474:Isotretinoin / Q000009:adverse effects*; D007641:Keratolytic Agents / Q000009:adverse effects*; D009364:Neoplasm Recurrence, Local / Q000601:surgery / Q000628:therapy; D009447:Neuroblastoma / Q000150:complications*
D007641:Keratolytic Agents; D015474:Isotretinoin