Korean J Med.  2013 Nov;85(5):545-550.

Hypercalcemia Refractory to Pamidronate Associated with Metastatic Calcifications in Multiple Organs

• Bae GB
• Eun JS
• Kim NR
• Im CH
• Nam EJ
• Kang YM

Abstract

Paget's disease of bone (PDB) is a disorder featuring high-level bone turnover associated with the presence of disorganized and immature bone tissue with excessive levels of fibrosis. The risk of deformity is very high. The etiology of PDB is not well understood, but includes both genetic and environmental factors among which is bone trauma. Hypercalcemia can occur as a complication of PDB in patients who are immobilized and dehydrated. However, to date, no case of severe hypercalcemia with metastatic calcifications in multiple organs has been reported in any PDB patient. The drugs of choice for treatment of PDB are bisphosphonates. These drugs effectively suppress bone turnover. Patients with extensive PDB may require higher doses of bisphosphonates, and acquired resistance to a particular bisphosphonate may be overcome by use an alternative drug. Here, we report a case of suspicion of PDB. The patient presented with hypercalcemia and metastatic calcifications and his condition improved dramatically after treatment with zoledronic acid.

Keyword

Hypercalcemia; Metastatic; Calcification; Pamidronate; Zoledronic acid

MeSH Terms

Bone and Bones
Congenital Abnormalities
Diphosphonates
Fibrosis
Humans
Hypercalcemia*
Imidazoles
Osteitis Deformans
Wounds and Injuries
Diphosphonates
Imidazoles