Severe Hypocalcemia due to Denosumab in Metastatic Prostate Cancer Essay

Severe Hypocalcemia due to Denosumab in Metastatic Prostate Cancer Essay

Length: 1038 words (3 double-spaced pages)

Rating: Strong Essays

Open Document

Essay Preview

Hypocalcemia is a rare and dangerous side effect of the drug Denosumab. We present a case of a patient with metastatic prostate cancer who developed severe hypocalcemia after the administration of the drug. A total of 80 gm of intravenous and 370 gm of oral calcium were administered in vain and a maximum ionized calcium level attained was 0.71mmol/ during the first 16 days of hospital stay. Due to worsening renal failure from tumor spread our patient needed dialysis to achieve normal calcium levels. Checking calcium and Vitamin D levels prior to administration of Denosumab is very vital in preventing this adverse outcome. By presenting this case we emphasize on the importance of checking Vitamin D levels prior to administration of the drug and also make other clinicians aware of a potential severe life threatening electrolyte imbalance.

Denosumab is a fully human monoclonal antibody, administered subcutaneously, that inhibits osteoclast mediated bone resorption in bone metastases from solid tumors and multiple myeloma. See Fig A below for details.

A 45-year-old gentleman with a 3-year history of metastatic (bone, liver & lymph nodes) prostate cancer and Hypertension presented to the hospital with worsening leg swelling and hematuria. He had been treated with androgen deprivation therapy in the past, along with 3 doses of zoledronic acid for bone metastases. The bone pains were not controlled with the above regimen and hence he was switched to Denosumab. Vitals at admission were within normal limits except Blood pressure of 160/90 mmHg. Pertinent findings on physical examination were the presence of bilateral lower extremity edema and negative Chvostek and Trousseaus’s signs. Review of symptoms was positive for hematuria and leg ...

... middle of paper ...

...ence and risk of denosumab-related hypocalcemia in cancer patients: a systematic review and pooled analysis of randomized controlled studies. Qi WX, Lin F, He AN, Tang LN, Shen Z, Yao Y.
3. Severe Hypocalcemia Following Denosumab Injection in a Hemodialysis PatientBrendan B. McCormick, MD, Janet Davis, MD, and Kevin D. Burns, MD
4. Pharmaceuticals and Medical Devices Agency.: ‹›, cited 19 April, 2013
5. Paller CJ, Carducci M, Philips G. Management of bone metastases in refractory prostate cancer—role of denosumab. Clin. Interv. Aging, 7, 363–372 (2012).

6. Buonerba C, Caraglia M, Malgieri S, Perri F, Bosso D, Federico P, Ferro M, Rizzo M, Palmieri G, Di Lorenzo G. Calcitriol: a better option than vitamin D in denosumab-treated patients with kidneyfailure? Expert Opin. Biol. Ther., 13, 149–151 (2013).

Need Writing Help?

Get feedback on grammar, clarity, concision and logic instantly.

Check your paper »

A Millimeter Too Far: Metastatic Melanoma Essays

- Summary Metastatic Melanoma is defined as the transformation of normal melanocytes due to unregulated growth factors involved in normal cell proliferation. Identifying the altered genes via mutation, deletion or amplification will enable us to find a treatment that is tailored to correct that particular gene. Introduction Melanoma determines skin pigmentation. Neural crest cells give rise to Melanocytes which transfer to the skin and hair follicles during embryonic progression. There are 5 phases in which melanoma develops, firstly nevus, then dysplastic nevus, next radial-growth phase, after that vertical growth phase and finally metastatic melanoma....   [tags: Disease, Disorders]

Strong Essays
1133 words (3.2 pages)

The War on Cancer and Its Oncolytic Viral Cells Essay

- Besides being able to seize an entire continent in the panicked grips of an epidemic, viruses also have the potential to do good. Such is the purpose of virotherapy – using viruses to selectively target and kill cancer cells, effectively stopping tumour growth in one fell swoop. In the war on cancer, the 200 types of cancer collectively claim almost half a million deaths yearly. The traditional tag team of radiation therapy and chemotherapy undoubtedly have their limits, and now more than ever are new developments needed....   [tags: virotherapy, metastatic, apoptosis]

Strong Essays
933 words (2.7 pages)

Severe Combined Immunodeficiency ( Scid ) Essay

- Physiology: All humans have an immune system designed to stop invading microbes, without this defence, many diseases cause death (Humphrey, John H). The immune system is comprised of white blood cells, including but not limited to the B and T cells (lymphocytes) (Humphrey, John H). These develop in the bone marrow in thymus. B cells attack the invaders by producing antibodies (Boundless). Similarly the T cells detect them and cause an immune response by releasing cytokines that release the macrophages and B cells....   [tags: DNA, Molecular biology, Immune system, Genetics]

Strong Essays
1359 words (3.9 pages)

Severe Air Pollution in China Essay

- After many years of ignoring the air pollution, smog ridden China has finally begun to take this issue more seriously. They are the worst country in the world when it comes to air pollution due to their huge population and large demand of manufactured goods (AFOP). This however is no excuse for what they do to the environment.This is a very important issue because of how much environmental damage can be prevented as well as setting an example of pollution reduction across the world. They must take this issue very seriously because air quality has gotten to the point where people are getting sick and dying there (The News Tribune, 2014)....   [tags: environment, population, atmosphere]

Strong Essays
1548 words (4.4 pages)

Essay about Schizophreni A Severe Brain Disorder

- Schizophrenia Angel Hernandez Keiser University Ms. Gutierrez Schizophrenia Schizophrenia is a severe brain disorder that affects how people perceive reality, express emotions, and interact with the environment (Supina & Patten, 2006). People with schizophrenia have difficulty identifying reality versus fiction (Supina & Patten, 2006). The symptoms of schizophrenia are divided into two groups: positive and negative (Supina & Patten, 2006). The positive symptoms involve disturbed speech and hallucinations, which consist of non-existent sensations, sounds, smells, images, and tastes (Supina & Patten, 2006)....   [tags: Schizophrenia, Psychosis, Hallucination]

Strong Essays
1425 words (4.1 pages)

Essay on Patient With Severe Dyspnoea

- I met a 47-year-old male, who presented to the secondary to consult for evaluation and management of severe dyspnoea. His difficulties became apparent about 6 months prior to the consultation, where he began to experience dyspnoea when walking up the stairs and into village, associated with chronic productive cough and cyanosis. 2 days prior to the consultation, his condition further deteriorated with worsening of dyspnoea that was present every day, and progression of chronic cough with increased phlegm production from 2-3 tablespoons to approximately 1 cups daily....   [tags: Differential Diagnosis]

Free Essays
1143 words (3.3 pages)

Severe Acute Respiratory Syndrome Essay

- SARS EPIDEMIC2 SEVERE ACUTE RESPIRATORY SYNDROME (SARS) Introduction Severe acute respiratory syndrome (SARS) is a pulmonary disease. It primarily affects the lungs and a virus that was initially discovered in 2003 causes it. Infection with the SARS virus results in symptoms of respiratory distress characterised by severe breathing difficulty that sometimes leads to death (Ramen, 2005). It is an infectious disease spread from human to human. There have not been any known cases of SARS anywhere in the world since 2004 (Acton, 2012)....   [tags: SARS, disease outbreaks]

Strong Essays
1752 words (5 pages)

Essay on Due Process

- Due Process The phrase "innocent until proven guilty" has been quoted for many years. In our society, we have labeled the accused person either guilty or not guilty without giving that person or persons their rith of due process. Webster's New World College Dictionary Fourth Edition says: "Due Process is the course of legal proceedings established by the legal system of a nation or state to protect individual rights and liberties." Due Process will allow an accused person time to go through the court proceeding, in hope of proving his or her innocence or guilt....   [tags: Justice System Due Process Law Essays]

Strong Essays
444 words (1.3 pages)

Plagiarism - A Severe Threat to the Society Essay

- Plagiarism - A Severe Threat to the Society Every day throughout the world, teachers strive to attain the most from their students in every aspect of life, from effective communication and language skills, to the development of individualism and the concept of being the best that you could be. With the use of exams, class discussions, and written assignments, educators subconsciously reinforce the idea that success can only be achieved from within, with personal expression and dedication to each and every task faced in modern existence....   [tags: Argumentative Persuasive Argument Essays]

Strong Essays
1073 words (3.1 pages)

Essay on Severe Acute Respiratory Syndrome

- Severe Acute Respiratory Syndrome, commonly known as SARS, first came onto the scene in November 2002 in mainland China. The respiratory disease is characterized by fever and coughing much like flu. While at first the etiological agent was unknown, through persistent research scientists discovered it to be a coronavirus. This causative agent created history because it was the first time it has ever been found in the human population. This coronavirus raised many questions for scientists as to why the pathogen causes morbidity and mortality....   [tags: Biology]

Strong Essays
649 words (1.9 pages)