Atypical osteomalacia after 2 year etidronate intermittent cyclic administration in osteoporosis

A 68-year-old postmenopausal woman with osteoporosis received intermittent cyclic etidronate therapy (400 mg/day). No concomitant diseases were noted. A baseline transiliac bone biopsy showed a high bone turnover without impairment due to mineralization. After 2 years of treatment, she had increased osteoid volume, and mineralization lag time corresponded to a variant form of osteomalacia called atypical osteomalacia. No clinical consequence was observed. This is the first case report of such a mineralization defect due to 2 year intermittent cyclic etidronate therapy.