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Acute pseudogout after pamidronate infusion.
Daniel Wendling1, Guillaume Tisserand, Vincent Griffond
1Department of Rheumatology, University Teaching Hospital Minjoz, EA 3186, University of Franche-Comté, Boulevard Fleming, Besançon, France. dwendling@chu-besancon.fr
Clinical Rheumatology
|May 27, 2008
Summary
Pamidronate infusions for shoulder hand syndrome can trigger acute pseudogout arthritis, a rare side effect. This condition, confirmed by synovial fluid analysis, may be linked to hypocalcemia.
Area of Science:
- Rheumatology
- Pharmacology
- Clinical Medicine
Background:
- Shoulder hand syndrome is a debilitating condition often treated with bisphosphonates.
- Pamidronate is a nitrogen-containing bisphosphonate commonly used for bone-related disorders.
Observation:
- A 72-year-old male patient received a 60-mg intravenous infusion of pamidronate for shoulder hand syndrome.
- Within hours of administration, the patient developed acute pseudogout arthritis in his right knee.
Findings:
- Synovial fluid analysis confirmed the diagnosis of pseudogout arthritis.
- The patient also presented with concurrent hypocalcemia.
- This adverse event is infrequently reported in medical literature.
Implications:
- This case highlights a potential, albeit rare, adverse effect of pamidronate therapy.
- The underlying mechanism linking pamidronate to pseudogout and hypocalcemia requires further investigation.
- Clinicians should be aware of this potential complication when prescribing pamidronate.
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