Foscarnet-related Hypercalcemia During CMV Treatment in an Infant With SCID: A Case Report and Review of Literature

Shira Rabinowicz ¹ Raz Somech ^1,3 Yonatan Yeshayahu ^1,2

¹Pediatric Department A, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer
²Pediatric Endocrinology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer
³Cancer Research Center, Pediatric Immunology Service, Jeffrey Modell Foundation (JMF) Center, Sheba Medical Center, Tel Hashomer

graph Foscarnet is a main treatment for disseminated cytomegalovirus (CMV) infection in immunocompromised patients. One of its documented side effects is hypocalcemia. Hypercalcemia, in contrast, was described anecdotally before, almost exclusively in adults with human immunodeficiency virus (HIV) infection or post transplantation. We describe a case of severe hypercalcemia during foscarnet treatment in an infant with IL-7Rα deficient severe combined immunodeficiency (SCID), resolved following treatment cessation. We speculate that this unusual side effect is caused by foscarnet binding to the inorganic matrix of bone.