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Severe hypocalcaemia following denosumab in a patient with cancer with vitamin D deficiency
  1. Kanramon Watthanasuntorn1,
  2. Haisam Abid1 and
  3. Rosana Gnanajothy2
  1. 1 Internal Medicine, Bassett Healthcare Network
  2. 2 Hematology/Oncology, Bassett Healthcare Network
  1. Correspondence to Dr Haisam Abid, haisam.abid{at}


Denosumab is a monoclonal antibody that has been widely used for the prevention of skeletal-related events in patients with cancer with solid tumours and bone metastases, and acts by reducing the release of calcium from bones into the bloodstream. Severe hypocalcaemia is a rare and dangerous side effect of denosumab. We present a case of a patient with metastatic prostate cancer who developed severe hypocalcaemia after receiving a single dose of denosumab. Further laboratory analysis showed that the patient had a low vitamin D level, which contributed to the development of hypocalcaemia. He required an inpatient admission for repeated doses of intravenous calcium.

  • Cancer - See Oncology
  • Cancer Intervention
  • Prostate Cancer

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  • Contributors Concept: KW, HA and RG. Review of articles: RG. Case presentation: KW and HA. Discussion: HA and KW. Draft revision: RG.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.