Refractory Shock Secondary to Denosumab-induced Severe Hypocalcaemia
  • Nouran Eshak
    Geriatric Division, Family Medicine Department, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
  • Mahmoud Abdelnabi
    Internal Medicine Department, Texas Tech University Health Sciences Center, Lubbock, Texas
  • Juthipong Benjanuwattra
    Internal Medicine Department, Texas Tech University Health Sciences Center, Lubbock, Texas
  • Amr Ismail
    Internal Medicine Department, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
  • Natnicha Leelaviwat
    Internal Medicine Department, Texas Tech University Health Sciences Center, Lubbock, Texas
  • Zeyad Elharabi
    Internal Medicine Department, Texas Tech University Health Sciences Center, Lubbock, Texas
  • John Culberson
    Geriatric Division, Family Medicine Department, Texas Tech University Health Sciences Center, Lubbock, Texas, USA

Keywords

Refractory shock, cardiogenic shock, denosumab, severe hypocalcaemia

Abstract

Denosumab is one of the most commonly used antiresorptive drugs for osteoporosis treatment and the prevention of skeletal-related events in cancer patients. The purpose of this case report is to highlight potentially life-threatening severe hypocalcaemia as a side effect of denosumab complicated by refractory shock that failed to respond to medical management including intravenous calcium, vasopressors and inotropes in an elderly man with a history of prostatic cancer.

VIEW THE ENTIRE ARTICLE

References

  • Hanley D, Adachi J, Bell A, Brown V. Denosumab: mechanism of action and clinical outcomes. Int J Clin Pract 2012;66:1139–1146.
  • Kim D. Hypocalcemia after the administration of denosumab in a patient with osteoporotic fracture and vitamin D deficiency. J Endocrinol Metabol 2022;12:111–115.
  • Laskowski LK, Goldfarb DS, Howland MA, Kavcsak K, Lugassy DM, Smith SW. A RANKL wrinkle: denosumab-induced hypocalcemia. J Med Toxicol 2016;12:305–308.
  • Tohme JF, Bilezikian JP. Hypocalcemic emergencies. Endocrinol Metab Clin North Am 1993;22:363–375.
  • Olson SW, Deal LE, Piesman M. Epinephrine-secreting pheochromocytoma presenting with cardiogenic shock and profound hypocalcemia. Ann Intern Med 2004;140:849–851.
  • Patell K, Ajay K, Al Armashi AR, Bawwab A, Ravakhah K. Life-threatening sustained hypocalcemia following denosumab use in metastatic prostate cancer. J Oncol Pharm Pract 2022;28:698–702.

    • Views: 470
    HTML downloads: 53
    PDF downloads: 334

    Published: 2022-12-23
    Issue: 2022: Vol 9 No 12 (view)

    How to cite:
    1.
    Eshak N, Abdelnabi M, Benjanuwattra J, Ismail A, Leelaviwat N, Elharabi Z, Culberson J. Refractory Shock Secondary to Denosumab-induced Severe Hypocalcaemia. EJCRIM 2022;9 doi:10.12890/2022_003706.

    Most read articles by the same author(s)