Does Etelcalcetide reverse myelofibrotic bone changes due to hyperparathyroidism? A case report

Vincenzo Antonio Panuccio; Rocco Tripepi; Adele Postorino; Bruna Greve; Elena Sabattini; Esther Natalie Oliva

doi:10.3389/fmed.2022.1050062

Does Etelcalcetide reverse myelofibrotic bone changes due to hyperparathyroidism? A case report

Front Med (Lausanne). 2023 Feb 23:9:1050062. doi: 10.3389/fmed.2022.1050062. eCollection 2022.

Authors

Vincenzo Antonio Panuccio^{1

2}, Rocco Tripepi², Adele Postorino¹, Bruna Greve³, Elena Sabattini⁴, Esther Natalie Oliva³

Affiliations

¹ Nephrology, Dialysis and Transplantation Unit, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy.
² Institute of Clinical Physiology, National Research Council, Reggio Calabria, Italy.
³ Hematology Unit, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy.
⁴ Sezione Emolinfopatologica, Istituto di Ematologia "Seragnoli", Policlinico S. Orsola, Bologna, Italy.

Abstract

Secondary hyperparathyroidism (SHPT) in dialysis is common. A young man on chronic hemodialysis with SHPT developed pancytopenia with resistant anemia requiring transfusions. A bone marrow biopsy showed grade 3 fibrosis, depleted cellularity, osteosclerosis, and decreased myelopoiesis. He initiated Etelcalcetide 7⋅5 mg 3 times weekly with improvement in SHPT concomitant with near normalization of blood counts. Marrow biopsy at 12 months showed clearance of marrow reticulin, improvement of osteosclerosis and normalization of bone trabeculae, cellularity and myelopoiesis. This is a unique case in which Etelcalcetide treatment is comparable to parathyroidectomy on SHPT and is associated with significant improvement in severe myelofibrosis.

Keywords: Etelcalcetide; bone change; dialysis (ESKD); hyperparatiroidism; myelofibrosis.

Publication types

Case Reports