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.
Diskin
Charles J
CJ
Auburn University, Opelika, AL 36801, USA. hndt512@bellsouth.net
Stokes
Thomas J
TJ
Dansby
Linda M
LM
Radcliff
Lautrec
L
Carter
Thomas B
TB
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