van den Berg Gerrit, Lilien Marc R, Knops Rutger R G, van Es Robert J J, van Dijk Atty T H, Keijzer-Veen Mandy G
Department of Pediatric Nephrology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands.
Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.
Front Pediatr. 2025 Jun 6;13:1583240. doi: 10.3389/fped.2025.1583240. eCollection 2025.
The use of the osteoclastogenesis inhibitor denosumab is increasing in pediatrics, especially in the treatment of giant cell tumor or granuloma of bone or jaw, aneurysmal bone cyst, and other rare bone disorders. Particularly in pediatric patients, adverse kidney effects-such as acute kidney injury (AKI), hypertension, and nephrocalcinosis-are a significant concern that has received little attention.
CASE-DIAGNOSIS/TREATMENT: In this report, we present three children who developed hypercalcemia-related AKI six months after discontinuation of denosumab treatment. Treatment of the hypercalcemia consisted of hyperhydration, and administration of furosemide, denosumab or bisphosphonate.
Clinicians should be aware of the side effects of denosumab for at least seven months after discontinuation of denosumab. Early diagnosis and prompt management of hypercalcemia will result in recovery of AKI, however long-term consequences cannot be ruled out.
破骨细胞生成抑制剂地诺单抗在儿科的使用正在增加，尤其是在治疗骨或颌骨巨细胞瘤、肉芽肿、动脉瘤样骨囊肿及其他罕见骨疾病方面。特别是在儿科患者中，不良肾脏影响，如急性肾损伤（AKI）、高血压和肾钙质沉着症，是一个重大问题，但很少受到关注。
病例诊断/治疗：在本报告中，我们介绍了三名儿童，他们在停用 地诺单抗治疗六个月后出现了与高钙血症相关 的急性肾损伤。高钙血症的治疗包括补液、呋塞米、地诺单抗或双膦酸盐的给药。
临床医生应在停用 地诺单抗后至少七个月内注意其副作用。高钙血症的早期诊断和及时处理将使急性肾损伤恢复，然而不能排除长期后果。
