lutetium-lu-177-dotatate and Water-Electrolyte-Imbalance

Peptide receptor radionuclide therapy (PRRT) is a molecular-targeted therapy in which a somatostatin analogue (a small peptide) is coupled with a radioligand so that the radiation dose is selectively administered to somatostatin receptor-expressing metastasized neuroendocrine tumors, particularly gastroenteropancreatic. Reported toxicities include myelotoxicity and nephrotoxicity, the latter manifesting as decreased kidney function, often developing months to years after treatment completion. We present a case of PRRT-induced kidney toxicity manifesting as a severe Gitelman-like tubulopathy with preserved kidney function. Because profound hypokalemia and hypocalcemia can lead to life-threatening arrhythmias, we highlight the necessity for careful monitoring of serum and urine electrolytes in patients receiving PRRT.

Topics: Acidosis; Aged; Calcitriol; Calcium Carbonate; Chemoradiotherapy, Adjuvant; Digestive System Surgical Procedures; Fluid Therapy; Gitelman Syndrome; Humans; Hypocalcemia; Hypokalemia; Ileal Neoplasms; Magnesium Sulfate; Male; Neuroendocrine Tumors; Octreotide; Organometallic Compounds; Vitamins; Water-Electrolyte Imbalance