Efficacy of denosumab in the treatment of hypercalcemic renal dysfunction in sarcoidosis: a case report.
Denosumab
Glucocorticoid-induced osteoporosis
Hypercalcemia
Renal dysfunction
Sarcoidosis
Journal
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
ISSN: 1433-2965
Titre abrégé: Osteoporos Int
Pays: England
ID NLM: 9100105
Informations de publication
Date de publication:
Apr 2024
Apr 2024
Historique:
received:
03
06
2023
accepted:
06
12
2023
pubmed:
16
12
2023
medline:
16
12
2023
entrez:
15
12
2023
Statut:
ppublish
Résumé
A 70-year-old female patient was admitted for close examination and treatment of hypercalcemia (corrected serum calcium levels: 3.04 mmol/L) and renal dysfunction (serum creatinine levels: 254.59 µmol/L). The patient had a history of sarcoidosis, diagnosed based on epithelioid cell granulomas in subcutaneous nodule biopsies, uveitis, and bilateral hilar lymphadenopathy, which had spontaneously remitted 10 years before admission. Because the patient was diagnosed with hypercalcemia associated with recurrent sarcoidosis, prednisone (20 mg/day) was initiated, and its dose was tapered following the decrease in serum calcium and creatinine levels. However, the levels of these parameters increased again when the prednisone dose was reduced to ≤ 4 mg/day. We were concerned about glucocorticoid-induced osteoporosis in the patient but hesitated to use first-line bisphosphonates because of renal dysfunction. Therefore, denosumab was initiated to reduce the risk of hypercalcemia, renal dysfunction, and glucocorticoid-induced osteoporosis. Serum creatinine and corrected serum calcium levels subsequently decreased. The prednisone dose could be reduced following repeated denosumab administration.Thus, denosumab can be a multifaceted, beneficial option for sarcoidosis-induced hypercalcemia, as it alleviates renal dysfunction indirectly by normalizing serum calcium levels, facilitates reduction of the glucocorticoid dose, and ameliorates glucocorticoid-induced osteoporosis.
Identifiants
pubmed: 38102330
doi: 10.1007/s00198-023-06998-y
pii: 10.1007/s00198-023-06998-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
733-736Informations de copyright
© 2023. International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.
Références
Hildebrand GK, Kasi A (2022) Denosumab, in: StatPearls [Internet]. StatPearls Publishing, Treasure Island (FL). https://www.ncbi.nlm.nih.gov/books/NBK535388/ . Accessed on May 31, 2023
Bone HG, Wagman RB, Brandi ML et al (2017) 10 years of denosumab treatment in postmenopausal women with osteoporosis: results from the phase 3 randomised FREEDOM trial and open-label extension. Lancet Diabetes Endocrinol 5:513–523. https://doi.org/10.1016/S2213-8587(17)30138-9
doi: 10.1016/S2213-8587(17)30138-9
pubmed: 28546097
Nasser SM, Sahal A, Hamad A, Elazzazy S (2019) Effect of denosumab versus zoledronic acid on calcium levels in cancer patients with bone metastasis: a retrospective cohort study. J Oncol Pharm Pract 25:1846–1852. https://doi.org/10.1177/1078155218820927
doi: 10.1177/1078155218820927
pubmed: 31694497
pmcid: 6838728
Torres-Ortiz A, Acharya P, Cheungpasitporn W (2019) Successful treatment of tuberculosis-associated hypercalcemia with denosumab in a patient with acute kidney injury. Ther Apher Dial 23:484–485. https://doi.org/10.1111/1744-9987.12788
doi: 10.1111/1744-9987.12788
pubmed: 30569532
Abd Jalil AA, Wan Muhamad Hatta SF, Mohamad AF, Abdul Rani MF (2021) Denosumab as the treatment of recalcitrant tuberculous pleural effusion-associated hypercalcemia. Case Rep Med 2021:5544848. https://doi.org/10.1155/2021/5544848
doi: 10.1155/2021/5544848
pubmed: 33986809
pmcid: 8079213
Alshakh R, Gendi N (2020) EP04 Hypercalcemia of sarcoidosis in a patient with severe renal impairment successfully treated with denosumab. Rheumatology 59(keaa109):003. https://doi.org/10.1093/rheumatology/keaa109.003
doi: 10.1093/rheumatology/keaa109.003
Raisz LG, Trummel CL, Holick MF, DeLuca HF (1972) 1,25-Dihydroxycholecalciferol: a potent stimulator of bone resorption in tissue culture. Science 175:768–769. https://doi.org/10.1126/science.175.4023.768
doi: 10.1126/science.175.4023.768
pubmed: 4333399
Wong GL, Luben RA, Cohn DV (1977) 1,25-Dihydroxycholecalciferol and parathormone: effects on isolated osteoclast-like and osteoblast-like cells. Science 197:663–665. https://doi.org/10.1126/science.195343
doi: 10.1126/science.195343
pubmed: 195343
Mori T, Horibe K, Koide M et al (2020) The vitamin D receptor in osteoblast-lineage cells is essential for the proresorptive activity of 1α,25(OH)2D3 in vivo. Endocrinology 161:bqaa178. https://doi.org/10.1210/endocr/bqaa178
doi: 10.1210/endocr/bqaa178
pubmed: 32987399
pmcid: 7575053
Weinstein RS, Chen JR, Powers CC et al (2002) Promotion of osteoclast survival and antagonism of bisphosphonate-induced osteoclast apoptosis by glucocorticoids. J Clin Invest 109:1041–1048. https://doi.org/10.1172/JCI14538
doi: 10.1172/JCI14538
pubmed: 11956241
pmcid: 150947
Hahn TJ, Halstead LR, Baran DT (1981) Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 52:111–115. https://doi.org/10.1210/jcem-52-1-111
doi: 10.1210/jcem-52-1-111
pubmed: 6969728
Suzuki Y, Ichikawa Y, Saito E, Homma M (1983) Importance of increased urinary calcium excretion in the development of secondary hyperparathyroidism of patients under glucocorticoid therapy. Metabolism 32:151–156. https://doi.org/10.1016/0026-0495(83)90221-4
doi: 10.1016/0026-0495(83)90221-4
pubmed: 6298567
Pearce G, Tabensky DA, Delmas PD, Baker HW, Seeman E (1998) Corticosteroid-induced bone loss in men. J Clin Endocrinol Metab 83:801–806. https://doi.org/10.1210/jcem.83.3.4621
doi: 10.1210/jcem.83.3.4621
pubmed: 9506731
Compston J (2018) Glucocorticoid-induced osteoporosis: an update. Endocrine 61:7–16. https://doi.org/10.1007/s12020-018-1588-2
doi: 10.1007/s12020-018-1588-2
pubmed: 29691807
pmcid: 5997116
Horiuchi K, Kobayashi E, Mizuno T, Susa M, Chiba K (2021) Hypercalcemia following discontinuation of denosumab therapy: a systematic review. Bone Rep 15:101148. https://doi.org/10.1016/j.bonr.2021.101148
doi: 10.1016/j.bonr.2021.101148
pubmed: 34825020
pmcid: 8605220
Dik WA, Heron M (2020) Clinical significance of soluble interleukin-2 receptor measurement in immune-mediated diseases. Neth J Med 78:220–231
pubmed: 33093245