title: Denosumab is Effective for Controlling Serum Calcium Levels in Patients with Humoral Hypercalcemia of Malignancy Syndrome: A Case Report on Parathyroid Hormone-related Protein-producing Cholangiocarcinoma.
abstract: Hypercalcemia resulting in the elevation of serum parathyroid hormone-related protein (PTHrP) and suppression of serum PTH was observed in a patient with advanced cholangiocarcinoma (CCC) and multiple lymph node metastases. We confirmed humoral hypercalcemia of malignancy based on PTHrP-producing CCC. Chemotherapy with gemcitabine and cisplatin could not control the patient's serum PTHrP levels and the patient was affected with bisphosphonate-refractory hypercalcemia. We administered a single dose of denosumab, an anti-receptor activator of nuclear factor-kappaB ligand monoclonal antibody, and the patient's serum calcium levels remained close to the normal range for approximately 3 weeks without additional treatment.
authors.affiliation: Department of Internal Medicine, Iida Municipal Hospital, Japan.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Ashihara
authors.forename: Koji
authors.initials: K
authors.lastname: Nakajima
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Mutsuhiro
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Kumiko
authors.initials: K
authors.lastname: Shirahata
authors.forename: Chika
authors.initials: C
authors.lastname: Maeda
authors.forename: Takeshi
authors.initials: T
authors.lastname: Uehara
authors.forename: Daisuke
authors.initials: D
authors.lastname: Gomi
authors.forename: Nobuo
authors.initials: N
authors.lastname: Ito
mesh_terms: D001650:Bile Duct Neoplasms / Q000150:complications; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002118:Calcium / Q000097:blood; D018281:Cholangiocarcinoma / Q000150:complications; D000069448:Denosumab / Q000627:therapeutic use*; D006801:Humans; D006934:Hypercalcemia / Q000097:blood* / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010257:Paraneoplastic Syndromes / Q000097:blood* / Q000188:drug therapy* / Q000209:etiology; D044162:Parathyroid Hormone-Related Protein / Q000097:blood; D011506:Proteins
chemical_list: D050071:Bone Density Conservation Agents; C470121:PTHLH protein, human; D044162:Parathyroid Hormone-Related Protein; D011506:Proteins; D000069448:Denosumab; D002118:Calcium