Related Experiment Videos
[Risedronate: a possible treatment for extraosseous calcification]
Naohiko Fujii1, Takayuki Hamano, Yoshitaka Isaka
1Department of Nephrology, Osaka University Graduate School of Medicine.
Clinical Calcium
|November 8, 2005
Summary
Risedronate effectively treated ectopic calcification in a CREST syndrome patient. This bisphosphonate resolved shoulder joint pain and improved mobility, indicating potential for managing such rare complications.
Area of Science:
- Rheumatology
- Endocrinology
- Orthopedics
Background:
- CREST syndrome can manifest with ectopic calcification, leading to joint pain and restricted mobility.
- Long-term steroid and NSAID use in this patient contributed to progressive shoulder dysfunction and extraosseous calcification.
- Standard laboratory tests revealed normal renal function and calcium/phosphate metabolism.
Observation:
- A 51-year-old female with CREST syndrome presented with significant ectopic calcification in her left shoulder joint.
- Despite prior treatments, her shoulder pain and limited range of motion worsened over three years.
- Risedronate was initiated for glucocorticoid-induced osteoporosis.
Findings:
- Following risedronate administration, the patient experienced rapid pain relief within a week and full range of motion recovery within a month.
- Radiographic evaluation at six months showed complete resolution of the ectopic shoulder calcification.
- Bone turnover markers (serum NTX, BSAP) showed no significant changes, suggesting a mechanism beyond direct bone remodeling.
Implications:
- Risedronate may offer a novel therapeutic approach for managing ectopic calcification in CREST syndrome.
- The mechanism of action might differ from other bisphosphonates like etidronate.
- This case highlights the potential of bisphosphonates in addressing rare extraskeletal manifestations of systemic autoimmune diseases.