Pamidronate Treatment for Hypercalcemia in an Infant Receiving Parenteral Nutrition

A 17‐day‐old infant who was delivered 8 weeks premature underwent small bowel resection for necrotizing enterocolitis. During treatment with continuous infusions of furosemide and hydrocortisone, his total calcium concentration had increased. The calcium dose in his parenteral nutrition solution was...

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Bibliographic Details
Published in:Pharmacotherapy 2004-07, Vol.24 (7), p.939-944
Main Authors: Bryowsky, Jason J., Bugnitz, Mark C., Hak, Emily B.
Format: Article
Language:English
Subjects:
Diphosphonates - therapeutic use
Humans
hypercalcemia
Hypercalcemia - blood
Hypercalcemia - drug therapy
Infant, Newborn
Male
pamidronate
parenteral nutrition
Parenteral Nutrition - adverse effects
pediatric patients
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Summary:A 17‐day‐old infant who was delivered 8 weeks premature underwent small bowel resection for necrotizing enterocolitis. During treatment with continuous infusions of furosemide and hydrocortisone, his total calcium concentration had increased. The calcium dose in his parenteral nutrition solution was decreased and then finally withheld. At 7 weeks of age and after 10 days of calcium‐free parenteral nutrition, pamidronate 3 mg (1.1 mg/kg) in 60 ml of normal saline was infused over 6 hours. The infant's total serum calcium concentration decreased, but then 6 days later it had increased again; pamidronate 2 mg (0.7 mg/kg) in 40 ml of normal saline over 4 hours was administered. The patient demonstrated no signs or symptoms of adverse reactions to pamidronate. His serum calcium concentration returned to normal, and calcium‐containing parenteral nutrition was tolerated. The use of pamidronate for treatment of hypercalcemia and chronic conditions that affect normal bone growth is increasing in children. Clinical trials in pediatric patients are necessary to determine how best to use bisphosphonates in this patient population.
ISSN:0277-0008
1875-9114
DOI:10.1592/phco.24.9.939.36103