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去颅咽管瘤术后因使用地舒单抗治疗骨质疏松导致低钙血症:1 例报告。

Post-craniopharyngioma surgery hypocalcemia due to denosumab use for osteoporosis: A case report.

机构信息

Department of Pharmacy, Yichang Central People's Hospital, Yichang, Hubei, China.

Institute of Pharmaceutical Preparation, China Three Gorges University, Yichang, Hubei, China.

出版信息

Medicine (Baltimore). 2024 Sep 13;103(37):e39649. doi: 10.1097/MD.0000000000039649.

Abstract

RATIONALE

Denosumab, a fully humanized IgG monoclonal antibody, is commonly employed in the management of different types of osteoporosis. Up to now, hypocalcemia linked with denosumab has been predominantly reported in dialysis patients suffering from chronic kidney disease. Interestingly, there have been no reports of hypocalcemia following craniopharyngioma surgery with the use of denosumab.

PATIENT CONCERNS

A 65-year-old male received a subcutaneous injection of denosumab (60 mg) as a treatment for osteoporosis following the resection of a craniopharyngioma. Remarkably, the patient developed hypocalcemia within 4 days post-injection. However, 6 months subsequent to the initial treatment, the patient underwent another subcutaneous injection of desmuzumab and once again experienced hypocalcemia.

DIAGNOSES

Hypocalcemia.

INTERVENTIONS

The hypocalcemia was successfully managed with intravenous calcium gluconate and oral calcium carbonate D3 tablets, leading to the alleviation of symptoms.

OUTCOMES

Hypocalcemia following the use of denosumab after craniopharyngioma surgery is rare, and its occurrence may be associated with the primary disease and concomitant medications.

LESSONS

It underscores the necessity for clinicians to perform a thorough evaluation of the patient's overall health status, complete all requisite testing, pay particular attention to those in high-risk categories, and ensure serum calcium levels are monitored, along with conducting other essential tests, prior to and following each administration of denosumab.

摘要

背景

地舒单抗是一种完全人源化 IgG 单克隆抗体,常用于治疗各种类型的骨质疏松症。迄今为止,与地舒单抗相关的低钙血症主要见于患有慢性肾脏病的透析患者。有趣的是,在使用地舒单抗治疗颅咽管瘤手术后,尚未有低钙血症的报告。

病例介绍

一名 65 岁男性在颅咽管瘤切除术后接受了地舒单抗(60mg)皮下注射治疗骨质疏松症。值得注意的是,该患者在注射后 4 天内出现低钙血症。然而,在初始治疗 6 个月后,该患者再次接受了地舒单抗皮下注射,再次出现低钙血症。

诊断

低钙血症。

干预措施

通过静脉注射葡萄糖酸钙和口服碳酸钙 D3 片成功治疗低钙血症,症状得到缓解。

结果

颅咽管瘤手术后使用地舒单抗后出现低钙血症较为罕见,其发生可能与原发病和伴随用药有关。

结论

这凸显了临床医生在使用地舒单抗前和后,对患者整体健康状况进行全面评估、完成所有必要检查、特别关注高风险人群、监测血清钙水平以及进行其他必要检查的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/168a/11404871/f5e185a83435/medi-103-e39649-g001.jpg

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