Neoplastic hypercalcemia: Physiologic response to intravenous etidronate disodium

Thomas P. Jacobs, Arlene C. Gordon, Shonni J. Silverberg, Elizabeth Shane, Lori Reich, Thomas Clemens, Carin M. Gundberg

Research output: Contribution to journalArticle

Abstract

Following a four-day control period during which an elevated serum calcium level either stabilized or continued to rise despite maximally tolerated saline diuresis, 12 patients with neoplastic hypercalcemia were treated with intravenous etidronate disodium (etidronate) 7.5 mg/kg/day for up to seven days. Serum calcium reverted to normal levels in all patients, with the mean pretreatment serum calcium level of 12.5 ± 0.4 mg/dl dropping to 9.2 ± 0.2 mg/dl (p <0.01) by Day 7. Elevated urinary calcium (1,107 ± 134 mg/g creatinine) and hydroxyproline levels (154 ± 16 mg/g creatinine) declined to 245 ± 52 mg/g creatinine and 75 ± 14 mg/g creatinine, respectively, suggesting a marked reduction in bone resorption following treatment. Serum phosphorus levels were unchanged, but urinary phosphorus levels dropped rapidly from 1,181 ± 125 mg/g creatinine before treatment to 723 ± 94 mg/g creatinine after two days. Serum parathyroid hormone levels (mid-molecule assay) were suppressed before treatment (64 ± 16 pg/ml), but rose rapidly to 223 ± 68 pg/ml by Day 7 of treatment. The value of serum 1,25-dihydroxyvitamin D was initially below normal (16 ± 3 pg/ml), but rose rapidly with treatment to 42 ± 12 pg/ml by Day 7. Symptoms of hypercalcemia and bone pain improved with treatment, and no serious adverse reactions to treatment were encountered. Intravenous etidronate is apparently an effective and safe treatment for neoplastic hypercalcemia.

Original languageEnglish (US)
Pages (from-to)42-50
Number of pages9
JournalAmerican Journal of Medicine
Volume82
Issue number2 SUPPL. 1
DOIs
StatePublished - Feb 23 1987
Externally publishedYes

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Etidronic Acid
Hypercalcemia
Creatinine
Serum
Calcium
Therapeutics
Phosphorus
Diuresis
Hydroxyproline
Bone Resorption
Parathyroid Hormone
Bone and Bones
Pain

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Jacobs, T. P., Gordon, A. C., Silverberg, S. J., Shane, E., Reich, L., Clemens, T., & Gundberg, C. M. (1987). Neoplastic hypercalcemia: Physiologic response to intravenous etidronate disodium. American Journal of Medicine, 82(2 SUPPL. 1), 42-50. https://doi.org/10.1016/0002-9343(87)90486-4

Neoplastic hypercalcemia : Physiologic response to intravenous etidronate disodium. / Jacobs, Thomas P.; Gordon, Arlene C.; Silverberg, Shonni J.; Shane, Elizabeth; Reich, Lori; Clemens, Thomas; Gundberg, Carin M.

In: American Journal of Medicine, Vol. 82, No. 2 SUPPL. 1, 23.02.1987, p. 42-50.

Research output: Contribution to journalArticle

Jacobs, TP, Gordon, AC, Silverberg, SJ, Shane, E, Reich, L, Clemens, T & Gundberg, CM 1987, 'Neoplastic hypercalcemia: Physiologic response to intravenous etidronate disodium', American Journal of Medicine, vol. 82, no. 2 SUPPL. 1, pp. 42-50. https://doi.org/10.1016/0002-9343(87)90486-4
Jacobs, Thomas P. ; Gordon, Arlene C. ; Silverberg, Shonni J. ; Shane, Elizabeth ; Reich, Lori ; Clemens, Thomas ; Gundberg, Carin M. / Neoplastic hypercalcemia : Physiologic response to intravenous etidronate disodium. In: American Journal of Medicine. 1987 ; Vol. 82, No. 2 SUPPL. 1. pp. 42-50.
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