[A toxic reaction of the oral mucosa to alendronate (Fosamax)].
A 90-year old woman attended a department of Oral and Maxillofacial Surgery with a tongue that had been painful for at least 3 months. Clinical examination revealed extensive bullous and ulcerative lesions located on the tongue, the oral vestibule and the buccal mucosa on both sides. A variety of diseases may be causative of ulcerative stomatitis: autoimmune diseases (like Pemphigus vulgaris, Erosive Lichen Planus, SLE or M. Crohn), or a viral, bacterial or mycotical infection, vitamin deficiency, a toxic reaction to medication or an immune deficiency. After an extensive, clinical examination, a definitive diagnosis still had not been achieved. The patient suffered from osteoporosis, for which she used alendronate (Fosamax). A study of the literature described a possible relationship between the occurrence of oral ulcers and the use of oral biphosphonates. Since a toxic reaction to alendronate was suspected, the use of Fosamax tablets was suspended. Three months later a complete recovery of the oral mucosa was observed.
Dik
E A
EA
Afdeling Mondziekten en Kaakchirurgie en Bijzondere Tandheelkunde van het Universitair Medisch Centrum Utrecht. e.a.dik@umcutrecht.nl
van Es
R J J
RJ
Bergsma
J E
JE
D000369:Aged, 80 and over; D019386:Alendronate / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D009061:Mouth Mucosa / Q000187:drug effects* / Q000473:pathology*; D010024:Osteoporosis / Q000188:drug therapy
D019386:Alendronate