Hypercalcemia

[Lisa Kottschade]

Has anyone seen severe hypercalcemia on patients treated with Ipi/Nivo? We have a patient from our team in the ICU right now with a calcium of 18, only has one bone metastasis, so clinical picture does not fit well. I see there are a couple of case reports in the literature, but nothing this severe.

Thank you!
Lisa

[Virginia Seery]

Lisa,
I have not seen severe hypercalcemia on the ipi/nivo combination. A calcium of 18 is certainly not subtle; I hope your patient does OK. Anyone else?

[Mollie Reed]

Oh, wow! We have not seen this either. It sounds like it could be from an autoimmune process, though. Have you all utilized steroids yet? Keep us posted on how this evolves. Very interested. I hope that it turns out well for the patient involved.

[Kathleen Madden]

We have not seen this either,yes, please keep us apprised of how your patient is doing. Hoping that they’ve already improved.

[Lisa Kottschade]

Thank you all. Unfortunately despite early intervention with steroids, dialysis, and PLEX, and getting the calcium down the patient passed away a couple of days ago. Very sad. We still really don’t have a cause, paraneoplastic panel was essentially negative.

[Kathleen Madden]

So sorry to hear this outcome, Lisa, thank you for letting us know.

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