Orbital inflammatory disease secondary to a single-dose administration of zoledronic acid for treatment of postmenopausal osteoporosis.
A 60-year-old woman received a single 5-mg dose of zoledronic acid (Aclasta) for treatment of postmenopausal osteoporosis. One day after receiving the drug, she acutely developed a painful periorbital swelling, chemosis, and hyperemia in the right eye. The condition worsened despite initial treatment with topical steroids. An orbital CT scan showed right eye proptosis, eyelid edema, and intraorbital fat stranding. A diagnosis of orbital inflammatory disease was made, and the patient was treated with high-dose oral steroids (prednisone 80 mg/day) tapered along 6 weeks. The symptoms and the swelling reduced progressively after initiating oral prednisone, and after 12 days, there was complete resolution of the condition. The patient remained symptom free and had no remission after the treatment interruption.
Procianoy
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Department of Ophthalmology and Otolaringology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. procianoy@yahoo.com
Procianoy
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D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D004164:Diphosphonates / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects*; D008875:Middle Aged; D009916:Orbital Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000188:drug therapy; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy*; D011241:Prednisone / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D000077211:Zoledronic Acid
D000893:Anti-Inflammatory Agents; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid; D011241:Prednisone