德诺苏马布 (denosumab) 给药后的严重低酸性血,通过仿剂成功管理
Makiko Omori1, Yukihiro Matsukawa2, Yuhachi Ikeda1
1Pediatrics, Shiga University of Medical Science, Otsu, Shiga, Japan.
BMJ case reports
|January 8, 2025
概括
德诺苏马布治疗可能会导致严重的低酸血和二次性偏甲状腺功能障碍症. 在一个年轻的骨髓瘤患者身上,Evocalcet有效地管理了这些由denosumab引起的电解质失衡.
科学领域:
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 丹诺苏马布是一种抗RANKL抗体,通过抑制骨质细胞活性来降低骨周转率.
- 副作用通常包括输液反应,发烧和低血症,但低血症通常没有报告.
- 像登索马布这样的骨质修饰剂可以诱导复杂的电解质干扰.
研究的目的:
- 在denosumab管理后报告严重的低酸血症和二次性副甲状腺功能障碍病例.
- 为了突出使用evocalcet成功管理denozumab诱导的低血症.
- 为了强调在denosumab治疗期间监测电解质和骨代谢标志物的重要性.
主要方法:
- 一个年轻男孩的病例报告,患有复发性骨髓瘤,接受了为骨转移治疗的德诺苏马布.
- 监测血清,,副甲状腺激素和其他电解质.
- 用,胆醇,补充剂进行治疗,然后再使用.
主要成果:
- 尽管患者接受了标准的补充剂,但患有低血症和严重的耐火性低血症.
- 实验室发现表明二次性偏甲状腺功能障碍是二次性的,而代诺苏马布诱导的低血是导致低酸血的原因.
- 埃沃卡塞特的使用使副甲状腺激素和水平正常化,使补充剂的停用成为可能.
结论:
- 德诺苏马布可以诱导严重的低酸血症和二次性甲状腺功能障碍症,需要仔细监测.
- 埃沃卡塞特在治疗药物诱导的二次性偏甲状腺功能障碍和低酸血症方面显示出潜在的有效性.
- 从骨修饰剂的电解质失衡的管理需要一个全面的方法.
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