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Hypercalcemia Induced by 13‐ cis ‐Retinoic Acid in a Patient with Neuroblastoma
Author(s) -
Belden Tara L.,
Ragucci Dominic P.
Publication year - 2002
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.22.8.645.33207
Subject(s) - retinoic acid , discontinuation , neuroblastoma , medicine , endocrinology , calcium , gastroenterology , urology , chemistry , biology , biochemistry , genetics , gene , cell culture
Hypercalcemia is a potential dosage‐related adverse effect of 13‐ cis ‐retinoic acid in patients with neuroblastoma. Severe hypercalcemia requiring dosage reduction has been reported in children receiving 13‐ cis ‐retinoic acid 200 mg/m 2 /day and in those with concurrent renal impairment receiving 160 mg/m 2 /day. A 12‐year‐old girl without renal dysfunction, diagnosed with neuroblastoma, developed severe hypercalcemia requiring several hospitalizations while receiving 13‐ cis ‐retinoic acid 160 mg/m 2 /day. Her hypercalcemia resolved with hydration, diuretic therapy, and temporary discontinuation of 13‐ cis ‐retinoic acid. Despite a 50% dosage reduction to 80 mg/m 2 /day, severe hypercalcemia recurred with the next treatment cycle. Further treatment with 13‐ cis ‐retinoic acid was made tolerable by shortening the duration of the remaining cycles. Serum calcium levels should be monitored in patients with neuroblastoma who receive 13‐ cis ‐retinoic acid.