A Case of Severe Hypercalcemia after Treatment with Teriparatide for Osteoporosis

Ja Won Koo; Jung Hoon Lee; Na Eun Jang; Hyuck Kim; Hwa Young Seok; Ye Ri So; A Ri Shin; Joo Hee Cho; Sang-Ho Lee

doi:10.11005/kjbm.2012.19.1.53

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Koo, Lee, Jang, Kim, Seok, So, Shin, Cho, and Lee: A Case of Severe Hypercalcemia after Treatment with Teriparatide for Osteoporosis

Case Report

Korean Journal of Bone Metabolism

Korean Journal of Bone Metabolism 2012; 19(1): 53-58.

Published online: 18 May 2012

DOI: https://doi.org/10.11005/kjbm.2012.19.1.53

A Case of Severe Hypercalcemia after Treatment with Teriparatide for Osteoporosis

Ja Won Koo, Jung Hoon Lee, Na Eun Jang, Hyuck Kim, Hwa Young Seok, Ye Ri So, A Ri Shin, Joo Hee Cho, Sang-Ho Lee

Department of Nephrology, Kyung Hee University Hospital at Gangdong, Seoul, Korea.

Address for Correspondence: Sang-Ho Lee, Department of Nephrology, Kyung Hee University at Gangdong 149 Sangil-Dong, Gangdong-Gu, Seoul, 134-727, Korea. Tel: +82-2-440-6121, Fax: +82-2-440-8150, rulale@dreamwiz.com

Received 16 April 2012 Revised 30 April 2012 Accepted 30 April 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/).

Abstract

Recombinant human parathyroid hormone 1-34 (rHPTH; 1-34, teriparatide) increases bone mass and increases osteoporotic fracture by stimulating new bone formation. It was approved in the United States for treatment of osteoporosis in men and women, and its effectiveness and safety was proved. Mild hypercalcemia was observed, but persistent and severe hypercalcemia was not observed in the studies of teriparatide. In this case, severe hypercalcemia was developed from patient having gait disturbance who was treated with vitamin D, calcium and teripartide for two months to treat osteoporosis after subtrochanteric fracture. Hypercalcemia was resolved with discontinuation of teriparatide. Severe hypercalcemia is not a common complication of teriparatide and monitoring of serum calcium level is routinely not recommended. But it is necessary to pay close attention to patients who were treated with teriparatide, especially in immobilized patients.

Keywords: Hypercalcemia, Osteoporosis, Teriparatide

Figures and Tables

Fig. 1

Dual-energy X-ray absorptiometry (DXA) of lumbar spine (A) and femur (B). (BMD, bone mineral density)

Fig. 2

Electrocardiogram (ECG) finding on admission.

Fig. 3

The changes of serum calcium during admission and follow-up.

Table 1

Bone mineral density (BMD) results of lumbar spine and femur

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