Schmid I, Stachel D, Schön C, Bauer M, Haas R J
Kinderklinik and Kinderpoliklinik, Dr. von Haunersches Kinderspital, University of Munich, Germany.
Klin Padiatr. 2001 Jan-Feb;213(1):30-4. doi: 10.1055/s-2001-11271.
Severe symptomatic hypercalcemia is a rare event in children with malignancies. Up to now there is limited experience treating childhood hypercalcemia with bisphosphonates in addition to calcitonin. We report a 5-year-old boy with acute lymphoblastic lymphoma who presented with malignant hypercalcemia at diagnosis. The maximal serum calcium concentration was 15.2 mg/dl (3.81 mmol/l). Conventional therapy with forced diuresis and furosemide failed. Calcitonin (10 IU/kg/24 h i.v. for 2 days) and pamidronate (1 mg/kg over 2 hours i.v.) were used successfully without adverse effect lowering the serum calcium level within 24 hours to normal values. We recommend the use of calcitonin and pamidronate as first-line therapy together with forced diuresis and furosemide in childhood hypercalcemia secondary to malignancies as it is rapidly effective and has no significant side effects.
严重症状性高钙血症在患有恶性肿瘤的儿童中是一种罕见事件。到目前为止，除了降钙素外，使用双膦酸盐治疗儿童高钙血症的经验有限。我们报告一名5岁急性淋巴细胞白血病男孩，诊断时出现恶性高钙血症。血清钙最大浓度为15.2mg/dl（3.81mmol/l）。常规的强制利尿和呋塞米治疗失败。降钙素（静脉注射10IU/kg/24小时，共2天）和帕米膦酸盐（静脉注射1mg/kg，超过2小时）成功使用，且无不良反应，血清钙水平在24小时内降至正常。我们建议在继发于恶性肿瘤的儿童高钙血症中，将降钙素和帕米膦酸盐与强制利尿和呋塞米一起作为一线治疗，因为它起效迅速且无明显副作用。
