骨坏死的下巴与磷酸盐治疗有关。

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Zarychanski R, Elphee E,沃尔顿P,约翰斯顿J

骨坏死的下巴与磷酸盐治疗有关。

J内科杂志。2006年1月,81 (1):73 - 5。

PubMed ID

16369966 (在PubMed

]

文摘

磷酸盐通常用于治疗和预防骨质疏松症,他们也是一种重要的辅助治疗多发性骨髓瘤和其他癌症骨转移。磷酸盐一般耐受性良好,与最小的不利影响;然而,存在一个越来越担心,静脉注射二磷酸盐使用与骨坏死的下巴(ONJ)。我们报告的发生骨坏死的下巴磷酸盐治疗12例诊断为多发性骨髓瘤,乳房癌,或肾细胞癌,所有涉及到骨头。在颚骨坏死的发病,磷酸盐治疗单一药物常见的所有12例。治疗不同的持续时间从12到77年前几个月骨坏死是观察;92%(11/12)的病例后下颌骨和所有病例耐火材料各种医学疗法,包括外科清创术和系统性的抗生素。可用的组织切片显示炎症与骨髓炎一致。活检,放线菌种虫害从文化中恢复过来,但没有扩展的克林霉素治疗授予临床受益。暴露的骨头的持久性仍然是一个重要来源为每个幸存患者发病率和疼痛。 Discontinuation of pamidronate therapy has not helped reverse the presence of osteonecrosis, and surgical manipulation of the involved site appears to worsen the underlying bone pathology. ONJ is an important adverse outcome associated with bisphosphonate therapy, and physicians prescribing pamidronate or zoledronate must be aware of the association between these drugs and this serious clinical entity. Failure to recognize the signs of ONJ can lead to unnecessary surgical procedures, which ultimately exacerbate the condition and impact quality of life. The unremitting nature of this clinical development, and the long-lasting morbidity associated with it suggests that patients should be counseled regarding the possible occurrence of ONJ prior to initiating therapy with pamidronate.

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药物

Pamidronic酸