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Bisphosphonate-associated arthritis.

Alejandro Diaz-Borjon1, Thorsten M Seyler, Natasha L Chen

  • 1Department of Medicine, Division of Rheumatology, Emory University School of Medicine, Atlanta, Georgia 30303, USA. adiazbo@emory.edu

Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases
|June 7, 2006
PubMed
Summary
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Intravenous bisphosphonates may induce arthritis in patients with metastatic breast cancer. Symptoms like knee pain and effusions resolved upon discontinuation, reappearing after re-administration.

Area of Science:

  • Oncology
  • Rheumatology
  • Pharmacology

Background:

  • Intravenous bisphosphonates are commonly used in treating metastatic breast carcinoma.
  • Arthropathy is not a widely recognized side effect of bisphosphonate therapy.

Observation:

  • A 51-year-old woman with metastatic breast cancer developed bilateral knee pain and effusions.
  • These symptoms occurred twice after receiving aminobisphosphonates and resolved upon discontinuation.

Findings:

  • Synovial fluid analysis ruled out infection, metastasis, and crystal-induced arthritis.
  • The patient experienced symptom recurrence upon rechallenge with a similar bisphosphonate, suggesting a drug-induced etiology.
  • Aminobisphosphonates are known to trigger an acute-phase response by stimulating proinflammatory cytokines.

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Implications:

  • Rheumatologists and oncologists should consider bisphosphonate-induced arthritis in patients presenting with joint pain.
  • This case highlights a potential adverse drug reaction that requires clinical awareness for accurate diagnosis and management.