Unusual Prolonged Hypocalcemia Due to Foscarnet in a Patient with AIDS

Phosphonoformic acid, a pyrophosphate analog known as foscarnet, is increasingly used in the treatment of refractory cytomegalovirus retinitis. It is well established that a transient decrease in ionized serum calcium concentration is temporally related to foscarnet infusions without affecting total...

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Bibliographic Details
Published in:Clinical infectious diseases 1997-10, Vol.25 (4), p.932-933
Main Authors: Guillaume, Marie Paule, Karmali, Rafik, Bergmann, Pierre, Cogan, Elie
Format: Article
Language:English
Subjects:
Acquired Immunodeficiency Syndrome - blood
Acquired Immunodeficiency Syndrome - complications
Acquired Immunodeficiency Syndrome - drug therapy
Antiviral Agents - adverse effects
Antiviral Agents - therapeutic use
Biological and medical sciences
Brief Reports
Calcium
Foscarnet - adverse effects
Foscarnet - therapeutic use
Humans
Hypocalcemia
Hypocalcemia - chemically induced
Immunodeficiencies
Immunodeficiencies. Immunoglobulinopathies
Immunopathology
Internal medicine
Magnesium
Magnesium - blood
Male
Medical sciences
Middle Aged
Parathyroid Hormone - blood
Vitamin D
Vitamin D - blood
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Summary:Phosphonoformic acid, a pyrophosphate analog known as foscarnet, is increasingly used in the treatment of refractory cytomegalovirus retinitis. It is well established that a transient decrease in ionized serum calcium concentration is temporally related to foscarnet infusions without affecting total serum calcium or parathyroid hormone (PTH) levels. This decrease seems to be due to a complex formation between phosphonoformate and free calcium. On the other hand, more-persistent, often symptomatic hypocalcemia may also occur, but the pathophysiological events leading to the decrease in both total and ionized calcium remain controversial. It has been recently suggested that hypomagnesemia has a role in this decrease. We report herein the time course of serum calcium, magnesium, PTH, and 1,25 (OH) sub(2) vitamin D in a patient with AIDS who presented with unusual persistent hypocalcemia due to prolonged administration of foscarnet.
ISSN:1058-4838
1537-6591
DOI:10.1086/597645