Cinacalcet in the treatment of hypercalcaemia and control of hyperparathyroidism due to ectopic parathyroid glands
Cinacalcet en el tratamiento de la hipercalcemia y control del hiperparatiroidismo por glándula paratiroides ectópica
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Hospital de Figueres, Figueres, Girona " "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "affc" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cinacalcet en el tratamiento de la hipercalcemia y control del hiperparatiroidismo por glándula paratiroides ectópica" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig1" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "10632_108_13133_en_10632_f1.jpg" "Alto" => 1065 "Ancho" => 1813 "Tamanyo" => 93010 ] ] "descripcion" => array:1 [ "en" => "Tc-sestamibi parathyroid scintigraphy" ] ] ] "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">To the Editor,</span></p><p class="elsevierStylePara">Cinacalcet is an allosteric modulator that stimulates the calcium-sensing receptor on the surface of parathyroid cells when activated by the extracellular calcium ion and inhibits parathyroid hormone (PTH) release. At the same time it decreases levels of serum phosphorus and calcium.<span class="elsevierStyleSup">1</span> This calcimimetic agent has established itself as a mainstay in the treatment of secondary hyperparathyroidism, and is also useful in persistent hyperparathyroidism after renal transplantation, in primary hyperparathyroidism and hyperparathyroidism due to parathyroid carcinoma.<span class="elsevierStyleSup">1-3</span></p><p class="elsevierStylePara">We report our experience in treatment with cinacalcet in a case of hyperparathyroidism and hypercalcaemia due to an ectopic mediastinal parathyroid gland in a patient with chronic renal failure (CRF). We found no cases of hyperparathyroidism due to ectopic thyroid glands treated with cinacalcet in the current literature. However, there were two cases of haemodialysis patients successfully treated with this drug<span class="elsevierStyleSup">4,5</span> who were affected by parathyromatosis (hyperfunctioning parathyroid tissue <br></br> distributed throughout the neck, which is a rare cause of recurrent hyperparathyroidism after total or subtotal parathyroidectomy).</p><p class="elsevierStylePara">We describe the case of an 80-year-old woman referred to our department two years before due to stage 4 CRF of unknown origin. She had a history of obesity, poorly controlled hypertension (HT), gout, post-thyroidectomy hypothyroidism, generalised osteoarthritis and a gastric ulcer. The analytical tests revealed the following data: creatinine 3.8mg/dl, serum calcium 10.7mg/dl, phosphorus 4.5mg/dl and iPTH 725ng/ml. Tc-Sestamibi parathyroid scintigraphy showed ectopic hyperfunctioning<span class="elsevierStyleBold"> </span>parathyroid tissue in the mediastinum (Figure 1). Cinacalcet treatment was started (under a compassionate use programme) at a dose of 30µg every other day. The frequency of administration had to be increased and, subsequently, resolution of the hypercalcaemia was observed and the treatment was withdrawn due to gastrointestinal intolerance. However, hypercalcaemia of 11.2mg/dl returned and creatinine had increased to 4.13mg/dl with clinical deterioration (fatigue, walking difficulty, and headache) treatment was resumed at 30µg every 48 hours. With good tolerance and evident clinical improvement, normalisation of calcaemia was achieved after a month. The cinacalcet dose was progressively increased to optimise iPTH figures and an arteriovenous fistula was subsequently performed to prepare the patient for renal replacement therapy, being the estimated glomerular filtration rate 13ml/min. One year after starting the calcimimetic treatment at a dose of 90µg and 60µg on alternate days, hypocalcaemia of 7.8mg/dl was found, therefore, oral calcitriol was added to the therapy. Two years after diagnosis, the patient had a good quality of life with creatinine levels of 4.17mg/dl, serum calcium of 8.4mg/dl and iPTH of 404ng/ml. The cinacalcet dose was 90µg and 60µg on alternate days and calcitriol 0.25µg per day. Concomitantly, a proper control of blood pressure was reached.</p><p class="elsevierStylePara">When a patient with advanced CKF presents hypercalcaemia, in addition to secondary hyperparathyroidism, autonomous hyperparathyroidism should also be considered, for example, hyperparathyroidism caused by an ectopic parathyroid adenoma. Hence the usefulness of Tc-Sestamibi scintigraphy in differential diagnosis.<span class="elsevierStyleSup">6</span> Cinacalcet may be useful in the treatment of hypercalcaemia and control of hyperparathyroidism due to hyperfunctioning ectopic parathyroid gland, thereby avoiding surgery in elderly patients with high comorbidity. This medication is generally well tolerated, with nausea and vomiting as the most frequent side effects. Hypocalcaemia may also develop in approximately 5% of patients receiving cinacalcet. This is rarely symptomatic and may be treated by changing or adjusting the dose of phosphorus binders containing calcium or administering vitamin D derivatives.<span class="elsevierStyleSup">1</span></p><p class="elsevierStylePara">As we noted in our patient, administration of cinacalcet helped to stabilise the progression of CKF and improve blood pressure control, thereby being able to decrease the dose and number of antihypertensive drugs.</p><p class="elsevierStylePara"><a href="grande/10632_108_13133_en_10632_f1.jpg" class="elsevierStyleCrossRefs"><img src="10632_108_13133_en_10632_f1.jpg" alt="Tc-sestamibi parathyroid scintigraphy "></img></a></p><p class="elsevierStylePara">Figure 1. Tc-sestamibi parathyroid scintigraphy </p>" "pdfFichero" => "P1-E515-S2802-A10632-EN.pdf" "tienePdf" => true "PalabrasClave" => array:1 [ "en" => array:4 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec441470" "palabras" => array:1 [ 0 => "Ectopic parathyroid gland" ] ] 1 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec441472" "palabras" => array:1 [ 0 => "Cinacalcet" ] ] 2 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec441474" "palabras" => array:1 [ 0 => "Hyperparathyroidism" ] ] 3 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec441476" "palabras" => array:1 [ 0 => "Hypercalcemia" ] ] ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig1" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "10632_108_13133_en_10632_f1.jpg" "Alto" => 1065 "Ancho" => 1813 "Tamanyo" => 93010 ] ] "descripcion" => array:1 [ "en" => "Tc-sestamibi parathyroid scintigraphy" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Block GA,\u{A0}Kevin JM, D Francisco AL, Turner SA, et al.\u{A0}Cinacalcet for secondary hyperparathyroidism in patients receiving hemodialysis. N Engl J Med 2004;350:1516-25. 2. Marcocci C, Chanson P, Shoback D, Bilezikian J, et al. Cinacalcet reduces serum calcium concentrations in patientes with intractable primary hyperparathyroidism. J Clin Endocrinol Metab 2009;94:2766-72. " "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Srinivas TR, Schold JD, Womer KL, Kaplan B, et al.\u{A0}Improvement in hypercalcemia with cincacalcet after kidney transplantation. Clin J Am Soc Nephrol 2006;1:323-6. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17699223" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Daphnis ED, Stylianou K, Katsipi I, Stratigis S, et al.\u{A0}Parathyromatosis and the challenge of treatment. Am J Kidney Dis 2006;48:502-5. <a href="http://www.ncbi.nlm.nih.gov/pubmed/16931226" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Unbehaun R, Lauerwald W. Successful use of cinacalcet HCl in a patient with end-stage renal failure and refractory secondary hyperparathyroidism due to parathyromatosis. Clin Nephr 2007;3:188-92." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Cabezas A, Bover J, Picazo M, Estorch M, et al.\u{A0}Hiperparatiroidismo autónomo en la insuficiencia renal crónica moderada-severa. XIX Reunión Anual de la Sociedad Catalana de Nefrología, 2003." 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| 2018 October | 80 | 23 | 103 |
| 2018 September | 82 | 10 | 92 |
| 2018 August | 55 | 20 | 75 |
| 2018 July | 57 | 11 | 68 |
| 2018 June | 47 | 14 | 61 |
| 2018 May | 52 | 14 | 66 |
| 2018 April | 52 | 5 | 57 |
| 2018 March | 53 | 9 | 62 |
| 2018 February | 66 | 7 | 73 |
| 2018 January | 41 | 4 | 45 |
| 2017 December | 64 | 12 | 76 |
| 2017 November | 43 | 1 | 44 |
| 2017 October | 49 | 9 | 58 |
| 2017 September | 40 | 10 | 50 |
| 2017 August | 36 | 6 | 42 |
| 2017 July | 42 | 10 | 52 |
| 2017 June | 44 | 3 | 47 |
| 2017 May | 54 | 11 | 65 |
| 2017 April | 33 | 4 | 37 |
| 2017 March | 35 | 19 | 54 |
| 2017 February | 34 | 13 | 47 |
| 2017 January | 39 | 5 | 44 |
| 2016 December | 39 | 4 | 43 |
| 2016 November | 60 | 2 | 62 |
| 2016 October | 116 | 7 | 123 |
| 2016 September | 111 | 1 | 112 |
| 2016 August | 123 | 4 | 127 |
| 2016 July | 157 | 4 | 161 |
| 2016 June | 112 | 0 | 112 |
| 2016 May | 120 | 0 | 120 |
| 2016 April | 91 | 0 | 91 |
| 2016 March | 87 | 0 | 87 |
| 2016 February | 98 | 0 | 98 |
| 2016 January | 104 | 0 | 104 |
| 2015 December | 140 | 0 | 140 |
| 2015 November | 81 | 0 | 81 |
| 2015 October | 94 | 0 | 94 |
| 2015 September | 65 | 0 | 65 |
| 2015 August | 77 | 0 | 77 |
| 2015 July | 62 | 0 | 62 |
| 2015 June | 44 | 0 | 44 |
| 2015 May | 49 | 0 | 49 |
| 2015 April | 6 | 0 | 6 |
Show all
