Pamidronic acid
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Osteonecrosis of jaw: case report A 62-year-old man developed osteonecrosis of jaw following treatment with pamidronic acid for non-uraemic calciphylaxis. The man was referred to the emergency department of hospital with pain and swelling in the left mandibular region, which had evolved over previous 2 months. He had a history of non-uraemic calciphylaxis and systemic sclerosis. Five years prior to the presentation, after the diagnosis of non-uraemic calciphylaxis, he had received IV pamidronic acid [sodium pamidronate] 60mg per week for 11 months without improvement, which was followed by sodium thiosulfate for 18 months. During the 3 years of treatment, the calciphylaxis lesions had reappeared and IV pamidronic acid 60mg per week had been restarted with continuation of sodium thiosulfate. He continued to receive pamidronic acid with concomitant sodium thiosulfate for the next 2 years. However, 3 months prior to the presentation, his IV treatment had been discontinued due to absence of peripheral venous access. On presentation, oral cavity examination revealed multiple cavities and purulent drainage through a bone-exposed area. A CT scan showed traces of fractures in the left region of the jaw bone, which confirmed the diagnosis of osteonecrosis of jaw secondary to pamidronic acid. The man’s treatment plan included unspecified antibacterials [antibiotics] and surgical debridement [outcome not stated]. Author comment: "This is a novel case of [osteonecrosis of jaw] associated with [pamidronic acid] treatment in a nonuremic calciphylaxis patient." Costa-Silva M, et al. Medication-Related Osteonecrosis of the Jaw in a Patient with Nonuremic Calciphylaxis. Skinmed 16: 424-426, No. 6, 21 Dec 2018. Available from: URL: https://www.ncbi.nlm.nih.gov/pubmed/30575515 803433766 Portugal
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Reactions 16 Nov 2019 No. 1779
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