Blackley S, Anderson K, Berg J
S Blackley, Medicine of the Elderly Department, Royal Victoria Building, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK. Email
J R Coll Physicians Edinb. 2015;45(2):133-5. doi: 10.4997/JRCPE.2015.209.
Denosumab is an emerging new treatment for osteoporosis in postmenopausal women and men with non-metastatic prostate cancer. It is largely used by specialists as an alternative treatment in patients with contraindications to traditional, more commonly used drugs such as bisphosphonates. One important side effect is hypocalcaemia, which may be life threatening. The risk of this is increased in renal impairment, mainly if eGFR < 30 ml/min/1.73m(2), and is exacerbated by vitamin D insufficiency. This is a case study of prolonged symptomatic hypocalcaemia after a single dose of denosumab in a patient with non-metastatic prostate cancer and moderate renal impairment (eGFR 40 ml/min/1.73m(2)). The patient presented with acute confusion, muscle cramps and myoclonic jerks 5 weeks after treatment. This case demonstrates the need to be aware of adverse effects of denosumab in mild-moderate renal impairment and the need to monitor calcium levels pre- and post-treatment.
地诺单抗是一种用于绝经后女性和患有非转移性前列腺癌男性骨质疏松症的新兴治疗方法。它主要被专家用作传统常用药物（如双膦酸盐）有禁忌证患者的替代治疗。一个重要的副作用是低钙血症，这可能危及生命。肾功能损害时这种风险会增加，主要是当估算肾小球滤过率（eGFR）<30 ml/min/1.73m²时，且维生素D不足会加剧这种情况。这是一例非转移性前列腺癌且有中度肾功能损害（eGFR 40 ml/min/1.73m²）患者单剂量使用地诺单抗后出现长期症状性低钙血症的病例研究。该患者在治疗5周后出现急性意识模糊、肌肉痉挛和肌阵挛性抽搐。本病例表明需要意识到地诺单抗在轻至中度肾功能损害中的不良反应，以及治疗前后监测钙水平的必要性。
