Abstract
HYPERCALCEMIA (serum calcium > 15 mg/dl) is often associated with malignancy, and because of its untoward cardiovascular, neurologic, and renal effects, generally requires immediate therapy. Although the recommended initial therapy for hypercalcemia in children is expansion of the extracellular fluid compartment with intravenous sodium chloride and diuresis with furosemide, ~ the efficacy of this regimen has been studied primarily in adults.'- :4 Attempts to increase urinary calcium excretion by this method are not only dangerous, owing to the large volume of fluid required, but also may be ineffective in patients whose hypercalcemia is the result of bone resorption from osseous metastases? '-' We report the cases of two children with hypercalcemia associated with lymphoma and bone metastases who failed to respond to extensive diuresis with intravenous sodium chloride infusions and furosemide. In each child, mithramycin, an antineoplastic antibiotic, was successful in lowering the concentration of serum calcium. We are unable to find previous reports using mithramycin to treat hypercalcemia in children.
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