TY - JOUR
T1 - Neoplastic hypercalcemia
T2 - Physiologic response to intravenous etidronate disodium
AU - Jacobs, Thomas P.
AU - Gordon, Arlene C.
AU - Silverberg, Shonni J.
AU - Shane, Elizabeth
AU - Reich, Lori
AU - Clemens, Thomas L.
AU - Gundberg, Carin M.
N1 - Funding Information:
From the College of Physicians and Surgeons of Columbia University, New York, New York; Bone Research Unit, Helen Hayes Hospital, West Haverstraw, New York; and. the Department of Human Biochemistry, Harvard University, Boston, Massachusetts. This work was presented in part at the June 1986 annual scientific meeting of the American Society for Bone and Mineral Research; it was supported in part by grants from the National Institutes of Health (RR-00645, AGO-4687, AM-35407, and AM-07271) and Norwich Eaton Pharmaceuticals, Inc. Requests for reprints should be addressed to Dr. Thomas P. Jacobs, Columbia Presbyterian Medical Center, 161 Fort Washington Avenue, New York, New York 10032. *Current address: Department of Orthopedics and Rehabilitation, Yale University, New Haven, Connecticut.
PY - 1987/2/23
Y1 - 1987/2/23
N2 - 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.
AB - 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.
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U2 - 10.1016/0002-9343(87)90486-4
DO - 10.1016/0002-9343(87)90486-4
M3 - Article
C2 - 3030098
AN - SCOPUS:0023632828
SN - 0002-9343
VL - 82
SP - 42
EP - 50
JO - The American journal of medicine
JF - The American journal of medicine
IS - 2 SUPPL. 1
ER -