Response to zolendronic acid in children with type III osteogenesis imperfecta

Panigrahi, Inusha; Das, Rashmi Ranjan; Sharda, Sheetal; Marwaha, Ram Kumar; Khandelwal, Niranjan

doi:10.1007/s00774-009-0149-4

Cited by 38 publications

(38 citation statements)

References 14 publications

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“…The elderly and cancer patients are at particular risk of vitamin D insufficiency due to limited Sun exposure, reduced dietary intake and renal impairment. In our experience in children with osteogenesis imperfecta, we found no clinical problems due to hypocalcemia in any of the patients [Panigrahi et al 2010].Rapid parenteral administration of bisphosphonates, might lead to hypocalcemia; however, it is infrequent and usually mild. So before initiating bisphosphonate therapy, any disturbances of mineral metabolism (calcium, magnesium) should be corrected.…”

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confidence: 50%

Seizure associated with zoledronic acid therapy: side-effects or coincidental finding?

Das

2011

Therapeutic Advances in Endocrinology

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Bisphosphonates have been used in a wide range of malignancies and bone disorders. Recently, there have been a few reports of seizure associated with alendronate and zoledronic acid. We discuss them, along with our experience with use of zoledronic acid.In a recent series, the authors described three cases of seizures that developed after the administration of zoledronic acid [Tsourdi et al. 2011]. However, among these three cases, hypoglycemia (caused by prior gastric surgery leading to dumping syndrome) was the predisposing factor behind two cases. In the third case, the patient developed a febrile seizure on the second day of zoledronic acid administration. The authors proposed that zoledronic acid induced an acute phase reaction that had lead to lowering of the seizure threshold and resulting seizure. However, the requirement for vasopressor support and response to iv antibiotics suggest intracranial infection rather than simple febrile seizure, which the authors have not ruled out by cerebrospinal fluid (CSF) analysis. In all three cases, the level of 25-(OH)-D has been described as low (<30 ng/ml). Importantly, there was no description about magnesium level.There are also another two cases of seizures reported in association with the administration of the above drugs, and in both reports, hypocalcemia was thought to represent the underlying mechanism [Navarro et al. 2007;Maclsaac et al. 2002]. However, if we go through these two reports, then the respective authors have described that it is the underlying vitamin D deficiency leading to hypocalcemia causing seizure rather than alendronate or zoledronic acid. The authors of both of the reports propose that the patients might have subclinical hypocalcemia before starting the drugs (as a result of vitamin D deficiency) which was aggravated by the administration of zoledronic acid.The risk factors for zoledronic-acid-induced hypocalcemia include pre-existing vitamin D deficiency, hypoparathyroidism, hypomagnesemia, and previous thyroid or parathyroid surgery [Tanvetyanon and Stiff, 2006]. These conditions impair the normal release and activity of parathyroid hormone which acts to compensate for low serum calcium by increasing renal absorption of vitamin D and calcium. Pre-existing vitamin D deficiency in a population receiving a bisphosphonate has also been reported in up to 27% [Wang-Gillam et al. 2008]. The elderly and cancer patients are at particular risk of vitamin D insufficiency due to limited Sun exposure, reduced dietary intake and renal impairment. In our experience in children with osteogenesis imperfecta, we found no clinical problems due to hypocalcemia in any of the patients [Panigrahi et al. 2010].Rapid parenteral administration of bisphosphonates, might lead to hypocalcemia; however, it is infrequent and usually mild. So before initiating bisphosphonate therapy, any disturbances of mineral metabolism (calcium, magnesium) should be corrected. Following the approval and widespread use of bisphosphonates, a number of potential side effects have be...

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Seizure associated with zoledronic acid therapy: side-effects or coincidental finding?

Das

2011

Therapeutic Advances in Endocrinology

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“…Bazıları ise otozomal resesif kalıtım göstermektedir (1,5). Olgumuzda genetik geçiş şekli spontan baskın mutasyon olarak değerlendirildi.…”

Section: Discussionunclassified

“…Olguların klinik tablosu hemen hiç belirti vermeyen hafif şekillerden ölü doğumla sonuçlanan ağır kemik kırılmalarına ve deformitelerine kadar geniş bir spektrum göstermekte olup her yaşta karşılaşıla-bilmektedir (2,4,5). Bu hastalık çoğunlukla klinik ve radyolojik bulgularıyla sekiz tip olarak sınıflandırıl-maktadır (6).…”

Section: Introductionunclassified

A Newborn With Osteogenesis Imperfecta Type III: The Importance Of Prenatal Diagnosis

Bulut¹,

Bulut²,

Içağasioğlu³

et al. 2010

Tepecik Dergisi

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ÖZETBu yazıda, antenatal izlemi olmayan 30 yaşındaki anneden doğan, yaşamının birinci gününde üst ve alt ekstremitelerinde çok sayıda kırıkları olan, soygeçmişinde iki kardeşinde ölüm öyküsü bulunan ve yenidoğan döneminde Osteogenezis İmperfekta Tip III tanısı alan bir olgu sunularak prenatal tanının önemi belirtilmiştir.Anahtar sözcükler: Osteogenezis imperfekta, prenatal tanı, yenidoğan. SUMMARYIn this paper, we report a one day old newborn with multiple fractures of extremities diagnosed as osteogenesis imperfecta type III in the neonatal period. In family history, there was the death of her two brothers. The importance of prenatal diagnosis. Of this antity was emphasized

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“…Zoledronate is given for 30 minutes every 6 months and pamidronate is infused for 4 hours every 3-4 months. 53,54 There is no data indicating that zoledronate is more effective in decreasing fracture rate compared to pamidronate. On the basis of this, zoledronate was designed to be administered yearly in adults with osteoporosis; the current practice of zoledronate therapy in children with OI remains to be assessed.…”

Section: Pathophysiology and Therapeutic Options In Oimentioning

confidence: 99%

“…Positive effects have been described following BP therapy such as increase of BMD, reduced bone turnover, reduction of fractures in children, increase in vertebral body height, relief of musculoskeletal pain, and improvement in mobility. 51,[54][55][56][57] Nonetheless, in contrast to the generally positive effect on fracture incidence in children, the effect on prevention of fractures in adults still requires further investigation. 57,58 Recent Cochrane reports assessed the results of BP treatment from meta-analyses of randomized and quasirandomized controlled clinical trials.…”

Section: Pathophysiology and Therapeutic Options In Oimentioning

confidence: 99%