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Intern Med. 2015;54(20):2637-42. doi: 10.2169/internalmedicine.54.4946. Epub 2015 Oct 15.

Rapid progression of vascular and soft tissue calcification while being managed for severe and persistent hypocalcemia induced by denosumab treatment in a patient with multiple myeloma and chronic kidney disease.

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Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan.


We herein present the case of a patient with myeloma and chronic kidney disease (CKD) who developed rapidly progressive vascular and soft tissue calcification during the course of treatment for severe hypocalcemia induced by the administration of denosumab for myeloma and hypercalcemia. Because a large amount of supplementation with active vitamin D and calcium was required to correct the severe hypocalcemia, rapidly progressive vascular calcification developed. Seeing that patients with CKD are prone to developing severe and prolonged hypocalcemia after denosumab treatment, physicians should closely monitor the patients' serum calcium levels and manage their hypocalcemia appropriately so as to avoid the development of significant ectopic calcification.

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