title: Predicting, Monitoring, and Managing Hypercalcemia Secondary to 13-Cis-Retinoic Acid Therapy in Children With High-risk Neuroblastoma.
abstract: 13-cis-retinoic acid is an established component of treatment for children with high-risk neuroblastoma. However, significant hypercalcemia is increasingly recognized as a potentially life-threatening dosage-related side effect. We present 2 patients with significant hypercalcemia secondary to 13-cis-retinoic acid and their management, and identified the predictive factors for susceptibility to hypercalcemia. Assessing glomerular filtration rate and concomitant medication help predict individual susceptibility to hypercalcemia. Calcium levels should be monitored at days 1, 7, and 14 of each course of retinoic acid. An algorithm for the management of hypercalcemia during the affected and subsequent cycles of retinoid therapy is proposed.
authors.affiliation: Departments of *Paediatric Endocrinology †Paediatric Haematology and Oncology, Royal Hospital for Sick Children, Glasgow, UK.
authors.forename: Suet Ching
authors.initials: SC
authors.lastname: Chen
authors.forename: Dermot
authors.initials: D
authors.lastname: Murphy
authors.forename: Jairam
authors.initials: J
authors.lastname: Sastry
authors.forename: Mohamad G
authors.initials: MG
authors.lastname: Shaikh
mesh_terms: D002118:Calcium / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003879:Dermatologic Agents / Q000009:adverse effects*; D019468:Disease Management; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006934:Hypercalcemia / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy*; D015474:Isotretinoin / Q000009:adverse effects*; D008297:Male; D008991:Monitoring, Physiologic; D009447:Neuroblastoma / Q000188:drug therapy*; D011379:Prognosis; D012307:Risk Factors
chemical_list: D003879:Dermatologic Agents; D015474:Isotretinoin; D002118:Calcium