title: Zoledronate as effective treatment for minimal trauma fractures in a child with STAT3 deficiency and osteonecrosis of the hip.
abstract: Signal transducer and activator of transcription 3 (STAT3) deficiency is a primary immunodeficiency characterized by eczema, complicated recurrent infections, elevated serum immunoglobulin E (IgE), osteopenia, and minimal trauma fractures. Zoledronic acid (ZA) is a long-acting bisphosphonate that has been successfully used in children with secondary osteoporosis and osteogenesis imperfecta. We describe the case of a 7-year-old male with STAT3 deficiency and minimal trauma fractures, who also developed osteonecrosis of the hip. He responded well to intravenous ZA every 6 months for 18 months. Three years later, he walks independently and unaided, and has not suffered any other fractures. Although more studies are needed, ZA might help reduce minimal trauma fractures in patients with STAT3 deficiency.
authors.affiliation: Clinical Immunology Department, Hospital de Especialidades, Mexican Social Security Institute (IMSS), Monterrey, Nuevo León, Mexico. tamarastaines@gmail.com.
authors.forename: Aidé Tamara
authors.initials: AT
authors.lastname: Staines Boone
authors.affiliation: Department of Molecular Biomedicine, Center for Research and Advanced Studies (CINVESTAV), National Polytechnic Institute (IPN), Mexico City, Mexico.
authors.forename: Julio César
authors.initials: JC
authors.lastname: Alcántara-Montiel
authors.affiliation: Department of Pediatrics, Hospital de Especialidades, Mexican Social Security Institute (IMSS), Monterrey, Nuevo León, Mexico.
authors.forename: Luz María
authors.initials: LM
authors.lastname: Sánchez-Sánchez
authors.affiliation: Department of Pediatrics, Hospital de Especialidades, Mexican Social Security Institute (IMSS), Monterrey, Nuevo León, Mexico.
authors.forename: Marina
authors.initials: M
authors.lastname: Arce-Cano
authors.affiliation: Department of Infectious Diseases, Hospital de Especialidades, Mexican Social Security Institute (IMSS), Monterrey, Nuevo León, Mexico.
authors.forename: Jorge
authors.initials: J
authors.lastname: García-Campos
authors.affiliation: Immunodeficiencies Research Unit, National Institute of Pediatrics (INP), Mexico City, Mexico.
authors.forename: Saúl Oswaldo
authors.initials: SO
authors.lastname: Lugo Reyes
mesh_terms: D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002648:Child; D004164:Diphosphonates / Q000627:therapeutic use*; D050723:Fractures, Bone / Q000188:drug therapy* / Q000209:etiology; D006615:Hip / Q000473:pathology*; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D008297:Male; D010020:Osteonecrosis / Q000188:drug therapy*; D050796:STAT3 Transcription Factor / Q000172:deficiency*; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D050796:STAT3 Transcription Factor; C494086:STAT3 protein, human; D000077211:Zoledronic Acid
keywords: STAT3 deficiency; arthroplasty; avascular necrosis of the hip; bisphosphonate; hyper-IgE syndrome; job syndrome; osteonecrosis of the femoral head; osteopenia; primary immunodeficiency; zoledronic acid