Találati lista | Tudóstér

001-es BibID:	BIBFORM061605
Első szerző:	Agarwal, Mohit
Cím:	Severe Symptomatic Hypocalcemia after Denosumab Administration in an End-Stage Renal Disease Patient on Peritoneal Dialysis with Controlled Secondary Hyperparathyroidism / Mohit Agarwal, Éva Csongrádi, Christian A. Koch, Luis A. Juncos, Vonda Echols, Mihály Tapolyai, Tibor Fülöp
Dátum:	2013
Megjegyzések:	We report the 1st case of severe, symptomatic hypocalcemia after denosumab (RANKLinhibitor) treatment in a peritoneal dialysis patient with secondary hyperparathyroidismand osteoporosis. A 58-year-old Caucasian female has been receiving chronicambulatory peritoneal dialysis for four years secondary to polycystic kidney disease.Laboratory studies revealed: albumin-corrected calcium 9.0 mg/dL, phosphorus 5 mg/dL,alkaline phosphatase (ALP) 58 U/L [normal, 40-105], albumin 3.4 gm/dL [normal, 3.6-5.4]and intact parathyroid hormone (PTH) 315 pg/mL [normal, 40-72]. Marked osteoporosiswas noted on the DXA scan, preventing her from renal transplantation considerations.She had failed conventional medical treatment, including per os calcium, monthlyergocalciferol (50,000 units/month), activated vitamin-D analog (doxercalciferol) andrenal-failure adjusted alendronate (70 mg twice a month). She was started onsubcutaneous denosumab 60 mg every 6 months. After her first dose, she developed aprogressive drop of calcium, phosphorus, bicarbonate and magnesium, in spite ofmassive escalation of doxercalciferol and calcium supplementation. Hypocalcemianadired at 6.3 mg/dL with symptomatic tetany, requiring a brief hospitalizationapproximately 7 weeks after denosumab treatment. Her elevated PTH rose furthertransiently (647 pg/mL), along with ALP (123 U/L). Bone-mineral parameters normalizedapproximately 3 months after denosumab administration. The observed phenomenonresembled the phenotype of "hungry bone syndrome" observed after surgicalparathyroidectomy.Conclusion: Treatment decisions based on bone densitometry results alone are nottransposable between patients with or without end-stage renal disease. Denosumab maylead to critical hypocalcemia in dialysis patients and further aggravate existing secondaryhyperparathyroidism.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	British Journal of Medicine & Medical Research. - 3 : 4 (2013), p. 1398-1406. -
További szerzők:	Csongrádi Éva (1969-) (szakorvos) Koch, Christian A. Juncos, Luis A. Echols, Vonda Tapolyai Mihály (1968-) (nefrológus) Fülöp Tibor (1957-) (kardiológus)
Internet cím:	Intézményi repozitóriumban (DEA) tárolt változat
Borító:
Saját polcon: