Orbital myositis induced by alendronate: A case report.
alendronate
bisphosphonates
orbital inflammation
orbital myositis
Journal
European journal of neurology
ISSN: 1468-1331
Titre abrégé: Eur J Neurol
Pays: England
ID NLM: 9506311
Informations de publication
Date de publication:
06 2023
06 2023
Historique:
revised:
22
02
2023
received:
05
09
2022
accepted:
02
03
2023
medline:
8
5
2023
pubmed:
8
3
2023
entrez:
7
3
2023
Statut:
ppublish
Résumé
Bisphosphonates are widely used, notably for osteoporosis treatment. Their common side effects are well known. However, they can trigger less common effects such as orbital inflammation. Here, the case is reported of an orbital myositis triggered by alendronate. This is a case report at an academic medical center. An orbital magnetic resonance imaging scan, a thoraco-abdominal computed tomography scan and blood sample analyses were performed. A 66-year-old woman treated by alendronate for her osteoporosis was investigated. She developed an orbital myositis after the first intake. Neurological examination revealed a painful diplopia with decreased downward and adduction movements of the right eye and edema of the upper eyelid. Orbital magnetic resonance imaging showed an orbital myositis of the right eye. No other cause of orbital myositis was found than the alendronate intake. After alendronate arrest and a short course of prednisone, the symptoms resolved. This case highlights that alendronate can cause an orbital myositis whose early diagnosis is of major importance because it is a treatable side effect.
Sections du résumé
BACKGROUND AND PURPOSE
Bisphosphonates are widely used, notably for osteoporosis treatment. Their common side effects are well known. However, they can trigger less common effects such as orbital inflammation. Here, the case is reported of an orbital myositis triggered by alendronate.
METHODS
This is a case report at an academic medical center. An orbital magnetic resonance imaging scan, a thoraco-abdominal computed tomography scan and blood sample analyses were performed.
RESULTS
A 66-year-old woman treated by alendronate for her osteoporosis was investigated. She developed an orbital myositis after the first intake. Neurological examination revealed a painful diplopia with decreased downward and adduction movements of the right eye and edema of the upper eyelid. Orbital magnetic resonance imaging showed an orbital myositis of the right eye. No other cause of orbital myositis was found than the alendronate intake. After alendronate arrest and a short course of prednisone, the symptoms resolved.
CONCLUSION
This case highlights that alendronate can cause an orbital myositis whose early diagnosis is of major importance because it is a treatable side effect.
Substances chimiques
Alendronate
X1J18R4W8P
Prednisone
VB0R961HZT
Diphosphonates
0
Types de publication
Case Reports
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1828-1830Informations de copyright
© 2023 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.
Références
McNab AA. Orbital myositis: a comprehensive review and reclassification. Ophthalmic Plast Reconstr Surg. 2020;36(2):109-117. doi:10.1097/IOP.0000000000001429
Pirbhai A, Rajak SN, Goold LA, et al. Bisphosphonate-induced orbital inflammation: a case series and review. Orbit. 2015;34(6):331-335. doi:10.3109/01676830.2015.1078380
Porras AG, Holland SD, Gertz BJ. Pharmacokinetics of alendronate. Clin Pharmacokinet. 1999;36(5):315-328. doi:10.2165/00003088-199936050-00002
Lefebvre DR, Mandeville JT, Yonekawa Y, Arroyo JG, Torun N, Freitag SK. A case series and review of bisphosphonate-associated orbital inflammation. Ocul Immunol Inflamm. 2016;24(2):134-139. doi:10.3109/09273948.2014.942747
Yang EB, Birkholz ES, Lee AG. Another case of bisphosphonate-induced orbital inflammation. J Neuroophthalmol. 2010;30(1):94-95. doi:10.1097/WNO.0b013e3181c1a589