골다공증 치료제 Teriparatide 치료 후의 중증 고칼슘혈증 1예
A Case of Severe Hypercalcemia after Treatment with Teriparatide for Osteoporosis
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초록
부갑상선호르몬 (테리파라타이드) 치료는 골의 동화작용을 촉진시킴으로써 골밀도를 증가시키는 약물로 폐경 후 골다공증 여성과 골절 위험이 높은 남성의 골다공증 환자의 치료제로 사용되고 있으며, 그 효과와 안정성이 입증되었다. 테리파라타이드 사용에 의한 경미한 고칼슘혈증은 보고되고 있으나, 중증의 고칼슘혈증의 보고는 매우 드물다. 본 증례는 대퇴골 골절로 수술 시행 후 골다공증 치료를 위해 비타민 D와 칼슘제제 및 테리파라타이드를 2개월간 사용한 이후 중증의 고칼슘혈증이 발생했던 경우로 문헌 고찰과 함께 보고하는 바이다.
Abstract
Recombinant human parathyroid hormone 1-34 (rHPTH; 1-34, teriparatide) increases bone mass and increases osteoporotic fracture by stimulating new bone formation. It was approved in the United States for treatment of osteoporosis in men and women, and its effectiveness and safety was proved. Mild hypercalcemia was observed, but persistent and severe hypercalcemia was not observed in the studies of teriparatide. In this case, severe hypercalcemia was developed from patient having gait disturbance who was treated with vitamin D, calcium and teripartide for two months to treat osteoporosis after subtrochanteric fracture. Hypercalcemia was resolved with discontinuation of teriparatide. Severe hypercalcemia is not a common complication of teriparatide and monitoring of serum calcium level is routinely not recommended. But it is necessary to pay close attention to patients who were treated with teriparatide, especially in immobilized patients.
참고문헌 (12)
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