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- Naoya Fujita, Yosuke Ono, Keiko Yamashita, Motohiro Kimata, Akinori Sekizawa, Kenichi Hashimoto, Yasuhiro Obuchi, and Yuji Tanaka.
- Department of General Medicine, National Defense Medical College, Japan.
- Intern. Med. 2024 Jul 15; 63 (14): 202720332027-2033.
AbstractAn 80-year-old man presented with electrolyte abnormalities, particularly hypocalcemia (3.6 mg/dL). He was diagnosed with bone and lymph node metastases from prostate cancer seven years earlier and continuously received goserelin, bicalutamide, and zoledronate. He later developed gradually worsening hypocalcemia, hypokalemia, hypophosphatemia, hypouricemia, renal dysfunction, and weight loss. Urinary potassium and phosphate loss, renal glucosuria, metabolic acidosis, and a low urine pH (5.0) were observed. Given the acquired onset and clinical course, we diagnosed the patient with zoledronate-induced proximal renal tubular acidosis. In the present case, severe hypocalcemia may have been caused by malnutrition and inappropriate long-term use of zoledronate.
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