Trochanteric hip fracture in an elderly patient with leprosy during osteoporosis treatment with risedronate and alfacalcidol.
There is no well-established treatment for osteoporosis in male patients with leprosy, because no clinical trials have examined the efficacy of treatment on bone mineral density (BMD) or fracture incidence in patients with leprosy. In this study, we report a case of osteoporosis in a man with leprosy, treated by oral administration of risedronate and alfacalcidol. An 82-year-old man with leprosy presented to our hospital with chronic back pain, due to osteoporosis, in July 2002. To prevent the progression of osteoporosis, oral administration of risedronate and alfacalcidol was started for this patient. An increase in forearm BMD and a decrease in the level of urinary crosslinked N-telopeptides of type I collagen (NTx) were observed in January 2003. The patient suffered a trochanteric fracture of the proximal femur at the end of March 2003. Surgical treatment with a sliding-screw plate was performed 5 days after the injury. Complete bony union of the right proximal femur was confirmed by radiography in July 2003. The above findings suggested that the treatment with risedronate and alfacalcidol contributed to the increase in BMD; however, the treatment did not prevent fracture due to osteoporosis in this male patient with leprosy.
Kanaji
Arihiko
A
Department of Orthopaedic Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan. akanaji@fujita-hu.ac.jp
Higashi
Masaaki
M
Namisato
Masako
M
Ando
Kenichi
K
Nakagawa
Masato
M
Yato
Yoshiyuki
Y
Ichinose
Hirofusa
H
Sakamaki
Toyonori
T
Yamada
Harumoto
H
D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000502:physiology; D012968:Etidronic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology; D006620:Hip Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D006887:Hydroxycholecalciferols / Q000008:administration & dosage / Q000627:therapeutic use*; D007918:Leprosy / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D008297:Male; D009166:Mycobacterium leprae / Q000502:physiology; D010024:Osteoporosis / Q000150:complications* / Q000188:drug therapy* / Q000382:microbiology; D011859:Radiography; D000068296:Risedronic Acid
D006887:Hydroxycholecalciferols; D000068296:Risedronic Acid; D012968:Etidronic Acid; C008088:alfacalcidol