Bisphosphonate-induced Severe Hypocalcemia: A Case Report.
10.11005/jbm.2012.19.2.139
- Author:
Won Seok DO
1
;
Jin Kyung PARK
;
Myung Il PARK
;
Hyeong Seok KIM
;
Sung Ho KIM
;
Duk Hyun LEE
Author Information
1. Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea. dhlee@fatima.or.kr
- Publication Type:Case Report
- Keywords:
Bisphosphonates;
Hypocalcemia;
Osteoporosis
- MeSH:
Aged;
Arthroplasty;
Calcitriol;
Calcium;
Calcium Gluconate;
Creatinine;
Diphosphonates;
Emergencies;
Female;
Femoral Neck Fractures;
Gluconates;
Hip;
Humans;
Hypocalcemia;
Imidazoles;
Osteoporosis;
Parathyroid Glands;
Plasma;
Vitamin D;
Vitamin D Deficiency
- From:Journal of Bone Metabolism
2012;19(2):139-145
- CountryRepublic of Korea
- Language:English
-
Abstract:
Bisphosphonate generally seems to be safe, but hypocalcemia may occasionally develop in the course of bisphosphonate treatment. Hypocalcemia induced by bisphosphonate is usually mild and asymptomatic, but unrecognized or poorly treated hypocalcemia can lead to life-threatening state. A 78-year-old woman who had a history of hip arthroplasty and intravenous zoledronate treatment for femur neck fracture was presented to emergency department with altered mental status. It turned out that her symptom was due to severe hypocalcemia which was caused by intravenous zoledronate treatment. She also had renal dysfunction. She was treated by intravenous calcium gluconate and calcitriol administration. This case supports the need for evaluation of renal dysfunction, vitamin D deficiency and parathyroid gland dysfunction before bisphosphonate treatment and accurate monitoring of plasma calcium and creatinine levels. In addition, vitamin D and calcium supply during treatment with bisphosphonate is mandatory.
