title: Severe hypocalcaemia and hypophosphataemia following intravenous iron and denosumab: a novel drug interaction.
abstract: We present the case of a 59-year-old woman with chronic kidney disease who suffered severe hypocalcaemia and hypophosphataemia after receiving denosumab and intravenous iron. This potentially life-threatening adverse drug interaction has never been reported before. We propose a mechanism to explain it with reference to the physiological derangements caused by both agents on calcium and phosphate homeostasis.
authors.affiliation: Department of Nephrology, St George Hospital, Sydney, New South Wales, Australia.
authors.forename: B
authors.initials: B
authors.lastname: Smyth
authors.affiliation: Department of Nephrology, St George Hospital, Sydney, New South Wales, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Ong
mesh_terms: D061605:Administration, Intravenous; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000097:blood; D000069448:Denosumab / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D004347:Drug Interactions / Q000502:physiology; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis*; D017674:Hypophosphatemia / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis*; D007501:Iron / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D008875:Middle Aged; D012720:Severity of Illness Index
chemical_list: D050071:Bone Density Conservation Agents; D000069448:Denosumab; D007501:Iron
keywords: chronic kidney disease; denosumab; hypocalcaemia; hypophosphataemia; intravenous iron; iron polymaltose