title: Pharyngolaryngeal ulcers associated with the improper use of alendronate.
abstract: Bisphosphonates can cause mucosal irritation. Although esophageal ulceration is a well-recognized adverse effect of bisphosphonates, pharyngolaryngeal ulcers associated with the improper use of oral bisphosphonates have rarely been described. A previously healthy 78-year-old woman presented with refractory pharyngolaryngeal ulcers. Extensive evaluation, including biopsy, bacterial culture, and blood tests did not identify any findings that indicated a specific disease diagnosis. Antibiotics and oral prednisolone were ineffective. Ultimately, it was found that the patient regularly took a tablet of alendronate, a type of bisphosphonate, by dissolving it in the oral cavity. Within 2 weeks after withdrawal of the use of the medication, her symptoms were eliminated, and the lesions were completely healed. This case illustrates the importance of correct administration of bisphosphonates. Given the widespread use of bisphosphonates, physicians need to be aware that their improper use can cause pharyngolaryngeal ulcers.
authors.affiliation: Department of Otorhinolaryngology - Head & Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan. Electronic address: hsakaida@clin.medic.mie-u.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sakaida
authors.affiliation: Department of Oncologic Pathology, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Yuasa
authors.affiliation: Department of Oncologic Pathology, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Fukutome
authors.affiliation: Department of Otorhinolaryngology - Head & Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Takeuchi
mesh_terms: D000368:Aged; D019386:Alendronate / Q000008:administration & dosage / Q000009:adverse effects*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000139:chemically induced*; D010024:Osteoporosis / Q000188:drug therapy*; D010608:Pharyngeal Diseases / Q000139:chemically induced*; D014456:Ulcer / Q000139:chemically induced*
chemical_list: D050071:Bone Density Conservation Agents; D019386:Alendronate
keywords: Adverse effect; Alendronate; Bisphosphonates; Improper use; Pharyngolaryngeal ulcer