title: [Symptomatic hypocalcaemia on denosumab use].
abstract: BACKGROUND
  Bone resorption inhibitors such as denosumab may induce symptomatic hypocalcaemia if a vitamin D deficiency is present. Amongst other causes, this type of deficiency may arise following bariatric surgery.
  
  
  METHODS
  We describe a 51-year-old woman who, a few years after undergoing bariatric surgery, developed symptomatic hypocalcaemia after she started taking denosumab.
  
  
  CONCLUSIONS
  An adequate calcium and vitamin D status is a general condition before prescribing medication to treat osteoporosis. Therefore we recommend that before starting treatment with a bone resorption inhibitor that not only the calcium but also the vitamin D status should be determined, and if necessary, optimised.
authors.affiliation: Amphia Ziekenhuis, afd. Interne Geneeskunde, Breda, the Netherlands. vbaptistalopes@amphia.nl
authors.forename: Vania
authors.initials: V
authors.lastname: Baptista Lopes
authors.forename: Debbie
authors.initials: D
authors.lastname: Robbrecht
authors.forename: Sjoerd
authors.initials: S
authors.lastname: van Thiel
authors.forename: Coen
authors.initials: C
authors.lastname: van Guldener
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects* / Q000627:therapeutic use; D050110:Bariatric Surgery / Q000009:adverse effects; D050071:Bone Density Conservation Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002136:Calcium, Dietary / Q000008:administration & dosage / Q000627:therapeutic use; D000069448:Denosumab; D005260:Female; D006304:Health Status; D006801:Humans; D006996:Hypocalcemia / Q000188:drug therapy / Q000209:etiology*; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy* / Q000209:etiology; D014807:Vitamin D / Q000008:administration & dosage / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000150:complications / Q000188:drug therapy
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D050071:Bone Density Conservation Agents; D002136:Calcium, Dietary; D014807:Vitamin D; D000069448:Denosumab