Refractory Shock Secondary to Denosumab-induced Severe Hypocalcaemia

  • Nouran Eshak Geriatric Division, Family Medicine Department, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
  • Mahmoud Abdelnabi Internal Medicine Department, Texas Tech University Health Sciences Center, Lubbock, Texas
  • Juthipong Benjanuwattra Internal Medicine Department, Texas Tech University Health Sciences Center, Lubbock, Texas
  • Amr Ismail Internal Medicine Department, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
  • Natnicha Leelaviwat Internal Medicine Department, Texas Tech University Health Sciences Center, Lubbock, Texas
  • Zeyad Elharabi Internal Medicine Department, Texas Tech University Health Sciences Center, Lubbock, Texas
  • John Culberson Geriatric Division, Family Medicine Department, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
DOI: https://doi.org/10.12890/2022_003706

Keywords

Refractory shock, cardiogenic shock, denosumab, severe hypocalcaemia

Abstract

Denosumab is one of the most commonly used antiresorptive drugs for osteoporosis treatment and the prevention of skeletal-related events in cancer patients. The purpose of this case report is to highlight potentially life-threatening severe hypocalcaemia as a side effect of denosumab complicated by refractory shock that failed to respond to medical management including intravenous calcium, vasopressors and inotropes in an elderly man with a history of prostatic cancer.

VIEW THE ENTIRE ARTICLE

References

  • Hanley D, Adachi J, Bell A, Brown V. Denosumab: mechanism of action and clinical outcomes. Int J Clin Pract 2012;66:1139–1146.
  • Kim D. Hypocalcemia after the administration of denosumab in a patient with osteoporotic fracture and vitamin D deficiency. J Endocrinol Metabol 2022;12:111–115.
  • Laskowski LK, Goldfarb DS, Howland MA, Kavcsak K, Lugassy DM, Smith SW. A RANKL wrinkle: denosumab-induced hypocalcemia. J Med Toxicol 2016;12:305–308.
  • Tohme JF, Bilezikian JP. Hypocalcemic emergencies. Endocrinol Metab Clin North Am 1993;22:363–375.
  • Olson SW, Deal LE, Piesman M. Epinephrine-secreting pheochromocytoma presenting with cardiogenic shock and profound hypocalcemia. Ann Intern Med 2004;140:849–851.
  • Patell K, Ajay K, Al Armashi AR, Bawwab A, Ravakhah K. Life-threatening sustained hypocalcemia following denosumab use in metastatic prostate cancer. J Oncol Pharm Pract 2022;28:698–702.

    • Published: 2022-12-23

    Issue: 2022: Vol 9 No 12 (view)

    Section: Articles

    How to cite:
    1.
    Eshak N, Abdelnabi M, Benjanuwattra J, Ismail A, Leelaviwat N, Elharabi Z, Culberson J. Refractory Shock Secondary to Denosumab-induced Severe Hypocalcaemia. EJCRIM 2022;9 doi:10.12890/2022_003706.

    Most read articles by the same author(s)