title: "Ghosts in my body": Seizure-like presentation of hypocalcemic tetany secondary to hypomagnesemia in a patient receiving cetuximab therapy for metastatic medulloblastoma.
abstract: Cetuximab, a monoclonal antibody specific for epidermal growth factor receptor, is increasingly used off-label and in early-phase trials for pediatric malignancies. Here, we report a patient with metastatic medulloblastoma receiving therapy with cyclophosphamide, vinblastine, and cetuximab. During evaluation for possible seizures, he was noted to be severely hypocalcemic, hypokalemic, and hypomagnesemic, a consequence of the blockade of renal epidermal growth factor receptor expression. His symptoms rapidly abated with intravenous electrolyte repletion. This case highlights the clinical heterogeneity of tetany and the importance of careful laboratory screening for known adverse effects of chemotherapy, particularly when newer biological agents are used off-study in combination chemotherapeutic regimens.
authors: *Pediatric Residency Program, University of Colorado Health Sciences Center †University of Colorado School of Medicine ‡Center for Cancer and Blood Disorders, Children's Hospital Colorado, Aurora, CO.
authors: Katie S
authors: KS
authors: Kidwell
authors: Whitney E
authors: WE
authors: Kopp
authors: Edythe A
authors: EA
authors: Albano
authors: Amy E Caruso
authors: AE
authors: Brown
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002528:Cerebellar Neoplasms / Q000188:drug therapy* / Q000473:pathology; D000068818:Cetuximab; D002675:Child, Preschool; D004573:Electrolytes / Q000008:administration & dosage*; D006801:Humans; D053565:Hypercalciuria / Q000139:chemically induced / Q000188:drug therapy; D008297:Male; D008527:Medulloblastoma / Q000188:drug therapy* / Q000473:pathology; D009362:Neoplasm Metastasis; D009397:Nephrocalcinosis / Q000139:chemically induced / Q000188:drug therapy; D015499:Renal Tubular Transport, Inborn Errors / Q000139:chemically induced / Q000188:drug therapy; D012640:Seizures / Q000139:chemically induced / Q000188:drug therapy; D013746:Tetany / Q000139:chemically induced / Q000188:drug therapy*
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D004573:Electrolytes; D000068818:Cetuximab