Malignancy-related hypercalcemia developing on a bisphosphonate but responding to calcitonin.
Bisphosphonates are considered a cornerstone for the treatment of hypercalcemia of malignancy, whereas calcitonin has not been found to be as potent. We report a case of severe hypercalcemia of malignancy that developed while the patient was taking alendronate that responded to the use of calcitonin. A 73-year-old woman developed hypercalcemia of malignancy while taking weekly alendronate. The patients' serum calcium remained above 15 mg/dL despite hydration and loop diuretics for 48 hours in addition to the bisphosphonates, and resistance was suspected. Intravenous calcitonin produced a dramatic decrease within 12 hours and normal serum calcium within 24 hours of treatment. Calcitonin might be useful for hypercalcemia of malignancy resistant to bisphosphonates.
Auburn University, Opelika, AL 36801, USA. hndt512@bellsouth.net
Charles J
CJ
Diskin
Thomas J
TJ
Stokes
Linda M
LM
Dansby
Lautrec
L
Radcliff
Thomas B
TB
Carter
D000368:Aged; D019386:Alendronate / Q000009:adverse effects* / Q000627:therapeutic use; D002116:Calcitonin / Q000627:therapeutic use*; D004164:Diphosphonates / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000139:chemically induced* / Q000209:etiology; D008175:Lung Neoplasms / Q000150:complications*
D004164:Diphosphonates; D002116:Calcitonin; D019386:Alendronate