Gross vertebral collapse associated with long-term disodium etidronate treatment for pelvic Paget's disease.
Inhibition of skeletal mineralisation is a well-recognized complication of disodium etidronate therapy that was identified in the earliest studies of its use in osteoporosis and Paget's disease. The effect is seen at lower doses in Paget's disease than in osteoporosis. Several cases of spontaneous fractures occurring in unaffected bones of Paget's patients have been reported. However, we believe the case described here is the most severe example of etidronate-induced osteomalacia published in the literature, featuring widespread vertebral collapse occurring as a consequence of nearly 10 years of uninterrupted etidronate treatment for isolated hemipelvic Paget's disease.
MacGowan
J R
JR
Division of Bone and Mineral Metabolism, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK.
Pringle
J
J
Morris
V H
VH
Stamp
T C
TC
D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D018771:Arthralgia / Q000139:chemically induced; D004164:Diphosphonates / Q000627:therapeutic use; D012968:Etidronic Acid / Q000009:adverse effects*; D005500:Follow-Up Studies; D005598:Fractures, Spontaneous / Q000139:chemically induced; D006801:Humans; D007738:Kyphosis / Q000139:chemically induced; D008159:Lumbar Vertebrae / Q000187:drug effects; D008297:Male; D010001:Osteitis Deformans / Q000188:drug therapy* / Q000201:enzymology; D010018:Osteomalacia / Q000139:chemically induced*; D010024:Osteoporosis / Q000139:chemically induced; D000077268:Pamidronate; D010384:Pelvic Bones / Q000187:drug effects*; D013122:Spinal Diseases / Q000139:chemically induced*; D016103:Spinal Fractures / Q000139:chemically induced; D013904:Thoracic Vertebrae / Q000187:drug effects
D000893:Anti-Inflammatory Agents; D004164:Diphosphonates; D000469:Alkaline Phosphatase; D012968:Etidronic Acid; D000077268:Pamidronate