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Biphosphonate complications

M Jalbert, A Mignot, A-S Gauchez, A-C Dobrokhotov, J Fourcade
INTRODUCTION: Hypercalcemia is not a rare event and can lead to severe consequences. Its main etiologies are primary hyperparathyroidism and neoplasic conditions. The iatrogenic etiology by vitamin D intoxication is more rarely found. CASE PRESENTATION: A 76-year-old finish woman comes to the emergency room for chest pain. Her medical history is impossible to specify due to the language barrier and initial confusion. She has severe hypercalcaemia (4.14mmol/L), renal insufficiency, cardiac arrhythmia later complicated by an ischemic cardiac episode...
April 27, 2018: Néphrologie & Thérapeutique
Dragos Apostu, Ondine Lucaciu, Gheorghe Dan Osvald Lucaciu, Bogdan Crisan, Liana Crisan, Mihaela Baciut, Florin Onisor, Grigore Baciut, Radu Septimiu Câmpian, Simion Bran
Titanium implants are widely used on an increasing number of patients in orthopedic and dental medicine. Despite the good survival rates of these implants, failures that lead to important socio-economic consequences still exist. Recently, research aimed at improving implant fixation, a process called osseointegration, has focused on a new, innovative field: systemic delivery of drugs. Following implant fixation, patients receive systemic drugs that could either impair or enhance osseointegration; these drugs include anabolic and anti-catabolic bone-acting agents in addition to new treatments...
February 2017: Drug Metabolism Reviews
Hampig Raphael Kourie, Joelle Antoun, Elie El Rassy, Marc Rassy, Claude Sader-Ghorra, Joseph Kattan
Osteonecrosis of the jaw (ONJ) is one of the most relevant and specific complication of biphosphonates. ONJ in patients receiving zoledronic acid every 3 to 4 weeks is frequently described, but the ONJ biyearly regimen used to reduce aromatase inhibitor associated bone loss (AIBL), is rarely reported. A literature review, focusing on the important trials using zoledronic acid to reduce AIBL, found that the mean risk of developing ONJ when zoledronic acid is used biyearly varies between 0.12% and 0.7%.
September 2015: Journal of Bone Oncology
H Hazan-Molina, D Aizenbud, Aizenbud D Dror
Hutchinson-Guilford progeria syndrome is an extremely rare condition classified as one of the premature ageing syndromes. This case presents a 16-year-old Israeli female patient, suffering from a variant of Hutchinson-Guilford progeria with a history of treatment with oral biphosphnates. The patient presented with typical cranial and facial features of the syndrome including delayed teeth eruption and root development probably due to insufficient jaw growth and severs retrognatic position of the maxilla and mandible...
2015: Journal of Clinical Pediatric Dentistry
Edgardo López-D'alessandro, Fabiana Mardenlli, Marisa Paz
Biphosphonate-associated maxillary bone osteonecrosis (BPMO) is a complication related to nitrogen-containing biphosphonate therapy. This adverse effect occasionally appears in patients who are administered biphosphonates through intravenous infusion for the treatment of cancer involving bone metastases. It can also present, in a lesser degree, in patients who take these drugs orally for the treatment of osteoporosis. Lately, there has been an increase in the number of cases of osteopenia and osteoporosis due to the increasing life expectancy of the world's population...
December 2014: Journal of Clinical and Experimental Dentistry
P L Patil, B Varun Rao
A 16 yr old female presented with generalized weakness and easy fatigability since 2 months. Her medical history included that she had sickle cell disease (ss pattern) on regular treatment. She denied smoking and consumption of alcohol. She had adequate calcium intake and her menstrual history was non-contributory. History of right tibial diaphysial fracture 1 year back followed by refracture at the same site 6 months later. On examination patient was 146 cm tall & weighed 48 kg. She had pallor, blue-grey sclera,scar mark of previous operation on right leg...
June 2013: Journal of the Association of Physicians of India
Maria Tolia, Anna Zygogianni, John R Kouvaris, Christos Meristoudis, Niki Margari, Petros Karakitsos, Ioannis Kokakis, Dimitrios Kardamakis, Christos Papadimitriou, Kyriaki Mystakidou, Nikolaos Tsoukalas, George Kyrgias, Basil Armonis, Dimitrios K Filippiadis, Alexios D Kelekis, Nikolaos Kelekis, Vasileios Kouloulias
UNLABELLED: The present review aims at providing an assessment of the clinical significance of Biphosphonates (BPs) in the treatment of patients with cancer. MATERIALS AND METHODS: A systematic literature review was performed based on database search in PubMed/Medline and included articles up to August 2013. RESULTS: BPs can reduce, delay, and prevent complications related to bone metastases. They improve mobility, functionality, pain, and quality of life...
January 2014: Anticancer Research
Giuseppe Rubini, Adriano Nicoletti, Domenico Rubini, Artor Niccoli Asabella
Skeletal metastases occur in many patients with different kinds of malignant tumors, especially in advance stage of breast cancer (in 47%-85% of patients), prostate cancer (33-85%), and lung cancer (32%-60%). The management of painful skeletal metastases is complicated and should be carried out by a multidisciplinary approach including conventional analgesics, antitumor therapy (chemo- and hormone therapy), osteoclast-inhibitory agents (bisphosphonates), corticosteroids, external-beam radiotherapy, surgery, and nuclear medicine therapy...
February 2014: Cancer Biotherapy & Radiopharmaceuticals
Carlos Escobar, Duarte Malveiro, António Salgado, Maria Inês Santos, João Lameirão Campagnolo, Manuel Cassiano Neves
INTRODUCTION/AIMS: Osteogenesis imperfecta (OI) is a genetic disorder characterized by bone fragility and osteopenia. Treatment involves a multidisciplinary approach and aims to improve the quality of life. The authors aimed to describe the characteristics of a sample of children with OI, to evaluate the treatment and clinical outcome before and after therapy. MATERIAL AND METHODS: An observational, longitudinal, retrospective and analytic study based on data obtained from the analisys of the clinical files of all patients with OI included in the pamidronate treatment protocol in Dona Estefânia's Hospital...
January 2013: Acta Médica Portuguesa
S Giannotti, V Bottai, G Dell'Osso, G De Paola, M Ghilardi, G Guido
Atypical femoral fractures can be subsequent to a long-term biphosphonates treatment; they have a high frequency of delayed healing. The authors describe a femoral pseudoarthrosis of an atypical fracture treated with intramedullary nailing in a female after prolonged alendronate therapy. Atypical femoral fractures can be subsequent to a long-term biphosphonates treatment even if, in the literature, there is no clarity on the exact pathogenetic mechanism. The Task Force of the American Society for Bone and Mineral Research described the major and minor features to define atypical fractures and recommends that all the five major features must be present while minor features are not necessary...
November 2013: Osteoporosis International
A Méndez-Gil, S Prat-Fabregat, A Domingo-Trepat, M Navarro-López, P Camacho-Carrasco, A Carreño-Delgado, J A Zumbado-Dijeres, R García-Elvira, M Ríos-Martín, R García-Tarriño, O Ares-Rodríguez, J R Ballesteros-Betancourt, S Suso-Vergara
AIM: Retrospective review of long term biphosphonates treated patients who sustained a subtrochanteric or diaphyseal femoral fracture with an atypical pattern. A literature review is presented as an update of the topic. MATERIAL AND METHODS: A retrospective study was conducted on 13 subtrochanteric or diaphyseal fractures in female patients treated with biphosphonates at our institution from September 2007 to March 2011. RESULTS: Four cases of subtrochanteric fractures and 13 diaphyseal fractures were detected...
March 2013: Revista Española de Cirugía Ortopédica y Traumatología
Mario Albani-Campanario, Gerardo Buendía-Díaz, María de Lourdes Flores-Islas, Carlos Maquita-Nakano, Josefina Ochoa-Cervantes
There are several treatment options for postmenopausic patients suffering from ostopenia or osteoporosis; one of them being inhibition of bone resorption using bisphosphonates. The most common side effects of these drugs are of gastrointestinal nature. There are, of course, other side effects that could jeopardize the function and integrity of other organs or systems. A case of a 58-year-old patient presenting zoledronic-acid induced uveitis symptoms is reported. The importance of this paper lies in that this complication is rather exceptional, in particular if associated with the biphosphonate in question...
May 2012: Ginecología y Obstetricia de México
Michelle Wilkison, Katherine Gauss, Yanchao Ran, Steve Searles, David Taylor, Nicole Meissner
HIV infection causes loss of CD4(+) T cells and type 1 interferon (IFN)-producing and IFN-responsive dendritic cells, resulting in immunodeficiencies and susceptibility to opportunistic infections, such as Pneumocystis. Osteoporosis and bone marrow failure are additional unexplained complications in HIV-positive patients and patients with AIDS, respectively. We recently demonstrated that mice that lack lymphocytes and IFN a/b receptor (IFrag(-/-)) develop bone marrow failure after Pneumocystis lung infection, whereas lymphocyte-deficient, IFN α/β receptor-competent mice (RAG(-/-)) had normal hematopoiesis...
July 2012: American Journal of Pathology
Girish M Fatterpekar, Julius Valentin Emmrich, Jean Anderson Eloy, Amit Aggarwal
OBJECTIVE: Osteonecrosis of the jaws is recognized as a serious complication of biphosphonate therapy. The purpose of this study was to characterize the computed tomography (CT) imaging appearance of biphosphonate-associated osteonecrosis and to evaluate for distinguishing features of radiation-induced osteonecrosis (RION), osteomyelitis (OM), and metastases. METHODS: We retrospectively reviewed CT scans of 6 patients with biopsy-proven biphosphonate-associated osteonecrosis (BAON)...
September 2011: Journal of Computer Assisted Tomography
Enrique Casado Burgos
Bisphosphonates are potent antiresorptive agents proven to be highly effective in vertebral and non-vertebral fractures. However, the reported complications associated with long-term use have led to questions on indefinite treatment. After administration of alendronate there is a high retention of the drug due to slow skeletal release as a result of bone resorption (half-life of more than 10 years), and it seems logical to propose a cessation of treatment (drug holidays) after prolonged treatment. The largest study published to date that assesses the effects on bone mineral density (BMD) and fractures with maintained or discontinued alendronate treatment is the FLEX (Fracture Intervention Trial Long-term Extension) trial...
September 2011: Reumatología Clinica
A Khan, G Lascaratos, T Rane-Malcolm, R Sanders
Zolendronic acid is a nitrogenous biphosphonate commonly used as an intravenous infusion for the management of Paget's disease, osteoporosis, and hypercalcemia of malignancy. We report a rare and challenging complication of zolendronate infusion: unilateral acute anterior uveitis followed by persistently raised intraocular pressure despite being on four different classes of antiglaucoma medication. The challenge was that the patient required topical steroid to treat her uveitis in the background of known glaucoma with corresponding steroid response...
2011: Clinical Ophthalmology
Nicos Skordis, Meropi Toumba
Bone is a dynamic organ, constantly changing metabolically and being remodelled through the balanced activity of osteoclast and osteoblast on trabecular surfaces. Osteoporosis represents a continuum, in which multiple pathogenic mechanisms converge to cause loss of bone mass and deterioration of microarchitecture of skeletal structure. In thalassaemia major (TM), progressive 'aging' of bone starts in early childhood, through the gradual development of an imbalance between augmented osteoclastic resorption and insufficient osteoblastic bone formation...
March 2011: Pediatric Endocrinology Reviews: PER
R Lenz, M Ellenrieder, R Skripitz, R Bader, C Pautke, W Mittelmeier, T Tischer
During the last several years the treatment of osteoporosis with bisphosphonates has become accepted as a safe and effective procedure. However, recently there have been increasing numbers of reports of rare complications in the literature. Particularly the occurrence of atypical fractures of the femur has become a focus of interest but the problem is insufficiently known and only rarely addressed in the scientific discussion. The case illustrated here and a survey of the important facts in the recent literature highlight essential aspects of long-term bisphosphonate therapy...
December 2011: Der Orthopäde
P Kľoc, L Tomčovčík, J Kľoc
The number of papers reporting the occurrence of specific pathological fractures in long-term biphosphonate users has recently increased. They refer to the forms of stress fracture probably resulting from an extreme decrease in bone turnover, which may involve sub-trochanteric or isolated transverse fractures, or short transverse fractures with a unicortical beak in an area of cortical hypertrophy. At the time of prodromal signs and symptoms, cortical bone at the site of impeding fracture appears rougher on radiographs...
2011: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
I Silva, M Mateus, J C Branco
Fibrous dysplasia of bone or Jaffe Lischtenstein's disease is a genetic, non-inheritable disease of bone development, characterized by bone pain, deformities and fracture, mainly observed in yo ung adults. The frequency is equal between sexes. Mutations in the gene coding the Gsα, GNAS complex, results in osteoblastic differentiation defects, and bone resorption. The disease can have a monostotic or polyostotic form, or be associated with café-au-lait skin spots and precocious puberty (McCune-Al bright syndrome)...
October 2010: Acta Reumatológica Portuguesa
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