Orbital Inflammatory Disease in A Patient Treated with Zoledronate |
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| Institution: | 1. Department of Internal Medicine,;2. Division of Endocrinology, Diabetes and Metabolism, SUNY Upstate Medical University, Syracuse, New York.;1. Parasite Control Laboratory, Pathology Department, Federal University of Maranhão, Brazil;2. Laboratorio de Farmacología Centro de Investigación Veterinaria de Tandil (CIVETAN)(CONICET-CICPBA-UNCPBA), Facultad de Ciencias Veterinarias, Universidad Nacional del Centro, Tandil, Argentina;1. Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands (T.J.v.R., E.H.C.v.D, H.M.A.F., G.D., C.J.F.B.);2. Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands (R.T.);3. Department of Ophthalmology, Bergman Clinics B.V., Velp, the Netherlands (P.J.H.P.);4. Department of Ophthalmology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands (R.M.H.D., R.O.S., C.J.F.B.);5. Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands (C.B.H.);1. Instituto de Investigación en Luz, Ambiente y Visión, Consejo Nacional de Investigaciones Científicas y Técnicas—Universidad Nacional de Tucumán, Tucumán, Argentina;2. Departamento de Luminotecnia, Luz y Visión, Facultad de Ciencias Exactas y Tecnología, Universidad Nacional de Tucumán, Tucumán, Argentina;3. Instituto de Investigaciones en Biodiversidad Argentina, Facultad de Ciencias Naturales e Instituto Miguel Lillo, Universidad Nacional de Tucumán, Tucumán, Argentina |
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| Abstract: | ObjectiveTo increase awareness of orbital inflammatory disease as a rare adverse effect of bisphosphonates.MethodsWe present a case report and a review of the relevant literature.ResultsA 57-year-old woman with history of esophageal, breast, and lung cancers was diagnosed with postmenopausal osteoporosis. She initially received intravenous ibandronate for a total of 6 infusions. Later, she was changed to zoledronate infusion because of its yearly dosing schedule. Several hours after her initial infusion of zoledronate, she developed a painfully swollen left eye with photophobia. Ophthalmologic exam showed edema of the left upper lid. No exophthalmos was noted. Slitlamp exam showed conjunctival injection in the left eye with an elevated intraocular pressure. An orbital computed tomographic scan showed inflammation of the left orbital, preseptal, and retroseptal spaces. She was started on 2 methylprednisolone dose packs and the swelling and erythema disappeared completely in 2 weeks. Subsequent orbital magnetic resonance imaging showed no mass within either the left or right orbit, and no abnormal enhancement following contrast administration.ConclusionPhysicians should be aware of this rare complication of zoledronate. It should be used with caution in patients with a history of inflammatory eye disease or mild ocular symptoms following use of a bisphosphonate. (Endocr Pract. 2011;17:e101-e103) |
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