Post-craniopharyngioma surgery hypocalcemia due to denosumab use for osteoporosis: A case report

• Published in: Medicine (Baltimore) 2024-09, Vol.103 (37), p.e39649
• Main Authors: Jia, Liangliang, Hu, Yueqin, Jin, Guilan
• Format: Article
• Language: English
• Subjects: Aged; Bone Density Conservation Agents - adverse effects; Bone Density Conservation Agents - therapeutic use; Calcium Gluconate - administration & dosage; Calcium Gluconate - therapeutic use; Clinical Case Report; Craniopharyngioma - drug therapy; Craniopharyngioma - surgery; Denosumab - adverse effects; Denosumab - therapeutic use; Humans; Hypocalcemia - chemically induced; Hypocalcemia - drug therapy; Hypocalcemia - etiology; Male; Osteoporosis - drug therapy; Pituitary Neoplasms - surgery; Postoperative Complications - drug therapy; Postoperative Complications - etiology
• ISSN: 1536-5964; 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000039649

Denosumab, a fully humanized IgG monoclonal antibody, is commonly employed in the management of different types of osteoporosis. Up to now, hypocalcemia linked with denosumab has been predominantly reported in dialysis patients suffering from chronic kidney disease. Interestingly, there have been no reports of hypocalcemia following craniopharyngioma surgery with the use of denosumab. A 65-year-old male received a subcutaneous injection of denosumab (60 mg) as a treatment for osteoporosis following the resection of a craniopharyngioma. Remarkably, the patient developed hypocalcemia within 4 days post-injection. However, 6 months subsequent to the initial treatment, the patient underwent another subcutaneous injection of desmuzumab and once again experienced hypocalcemia. Hypocalcemia. The hypocalcemia was successfully managed with intravenous calcium gluconate and oral calcium carbonate D3 tablets, leading to the alleviation of symptoms. Hypocalcemia following the use of denosumab after craniopharyngioma surgery is rare, and its occurrence may be associated with the primary disease and concomitant medications. It underscores the necessity for clinicians to perform a thorough evaluation of the patient's overall health status, complete all requisite testing, pay particular attention to those in high-risk categories, and ensure serum calcium levels are monitored, along with conducting other essential tests, prior to and following each administration of denosumab.