Reversible bone pain and symmetric bone scan uptake in a dialysis patient treated with cinacalcet: a case report

INTRODUCTION: The medical management of secondary hyperparathyroidism in patients with end-stage renal disease involves a combination of dietary restrictions, phosphate binders, active vitamin D analogs, and calcimimetics. CASE PRESENTATION: We report the case of a 36-year-old Hispanic dialysis patient, originally from Cuba and now residing in the USA, who developed severe bone pain and muscle twitching after starting low dose cinacalcet, despite normal pre-dialysis ionized calcium and elevated parathyroid hormone. The clinical symptoms correlated with increased symmetrical uptake on bone scan that resolved rapidly upon discontinuation of cinacalcet. CONCLUSION: Cinacalcet may induce severe bone pain and a unique bone scan uptake pattern in hemodialysis patients.