title: Hypercalcemia induced by 13-cis-retinoic acid in a patient with neuroblastoma.
abstract: 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.
authors.affiliation: Department of Pharmacy, Duke University Health System, Durham, North Carolina, USA.
authors.forename: Tara L
authors.initials: TL
authors.lastname: Belden
authors.forename: Dominic P
authors.initials: DP
authors.lastname: Ragucci
mesh_terms: 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*
chemical_list: D007641:Keratolytic Agents; D015474:Isotretinoin