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de Beus et al. report a case of a patient with immobilization-related hypercalcaemia and advanced renal insufficiency that did not respond to bisphosphonates, and after a single dose of denosumab (60 mg), a rapid and sustained decrease of the serum calcium concentration was observed with a transient hypocalcaemia which needed the introduction of oral calcium and active vitamin D to correct it [1]. Simultaneously with hypocalcaemia, the patient showed a moderate increase in parathyroid hormone (PTH) levels in blood.

Dramatic increase in parathyroid hormone and hypocalcaemia after denosumab in a kidney transplanted patient