Severe hypophosphatemia following denosumab administration i
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Bone metastasis is a frequent problem in patients with prostate cancer, breast cancer, and lung cancer, and about 75% of patients with metastatic cancer have bone metastases. These metastases are characterized by activation of osteoclasts and can cause severe skeletal-related events (SRE), which are defined as pathological fracture, radiation therapy or surgery for bone metastases, or spinal cord compression. In a 68-year-old man on maintenance hemodialysis (HD), severe anemia was detected. Bone marrow biopsy was performed for investigation of pancytopenia and pathological examination revealed adenocarcinoma of the prostate. Prostate specific antigen (PSA) was 574 ng/mL. After androgen deprivation therapy was initiated, PSA decreased to 13.7 ng/mL. But subsequent elevation of PSA and pain due to bone metastases were recognized. Denosumab (120 mg) was administered. Although improvement of bone pain was observed, severe hypocalcemia occurred. Severe hypophosphatemia was subsequently detected...

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