Severe prolonged hypocalcaemia following pamidronate for malignant hypercalcaemia

Clin Oncol (R Coll Radiol). 1998;10(6):407-9. doi: 10.1016/s0936-6555(98)80045-9.

Abstract

Hypercalcaemia of malignancy is a frequent occurrence. First line treatment of this condition involves the use of bisphosphonates. This report sets out the clinical findings in a patient presenting with metastatic breast cancer and hypercalcaemia (corrected serum calcium 3.72 mmol/l) who had received previous surgery for a parathyroid adenoma. After treatment with pamidronate, profound, prolonged (more than 60 days) symptomatic hypocalcaemia was observed. We discuss the possible explanations for these observations and conclude that a normal parathyroid reserve is probably necessary for the smooth normalization of blood calcium when bisphosphonates are used to treat malignant hypercalcaemia.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / complications
  • Adenocarcinoma / drug therapy*
  • Adenocarcinoma / secondary
  • Adenoma / surgery
  • Aged
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bone Neoplasms / secondary
  • Breast Neoplasms / complications
  • Breast Neoplasms / drug therapy*
  • Diphosphonates / administration & dosage
  • Diphosphonates / adverse effects*
  • Female
  • Humans
  • Hypercalcemia / drug therapy*
  • Hypercalcemia / etiology
  • Hypocalcemia / chemically induced*
  • Pamidronate
  • Paraneoplastic Syndromes / drug therapy*
  • Paraneoplastic Syndromes / etiology
  • Parathyroid Neoplasms / surgery
  • Parathyroidectomy

Substances

  • Antineoplastic Agents
  • Diphosphonates
  • Pamidronate