外耳道骨髓瘤在两名接受德诺苏马布治疗的患者身上
Holly Wang1, Matthew Yii2, Bing Mei Teh2,3
1Department of Endocrinology, Austin Health, Melbourne, 3084, Australia.
JBMR plus
|September 10, 2025
概括
外耳通道与药物相关的骨髓缩 (MROEAC) 是抗吸收药物 (如denosumab) 的罕见并发症. 早期识别和保守的管理,包括局部治疗和双酸盐治疗,是治愈的关键.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
背景情况:
- 与药物相关的下骨硬化 (MRONJ) 是抗吸收疗法的已知并发症.
- 外耳道与药物相关的骨髓缩 (MROEAC) 是一种更为罕见的疾病,主要与双酸盐使用有关.
- MROEAC的病理生理学是多因素的,涉及骨重塑抑制,血管新生变化,感染和炎症.
研究的目的:
- 报告两例与登苏马布相关的MROEAC.病例.
- 突出MROEAC的认可不足以及缺乏常规的听觉通道评估协议.
- 讨论MROEAC.潜在的管理策略.
主要方法:
- 介绍了两个不同的患者病例 (A病例和B病例),其中骨质疏松症患者接受了denosumab治疗.
- 保守的管理包括局部皮质类固醇,抗微生物药物,抗真菌药物和停止使用登苏马布.
- 随后用特里巴拉提德和瑞塞德酸盐进行治疗,监测骨循环标志物和听觉通道愈合.
主要成果:
- 两位患者均出现单侧耳,并被诊断为MROEAC.
- 保守的管理和停止使用登苏马布导致骨周转率标志物升高.
- 在这两种情况下,RISEDRONATE疗法导致骨标记物减少和听觉通道表皮化/愈合.
结论:
- MROEAC是抗吸收疗法的潜在罕见并发症,需要考虑除了下巴之外.
- 对于MROEAC的最佳治疗是不确定的,但保守措施和双酸盐测序显示出希望.
- 在抗吸收治疗前或期间进行常规的听觉通道评估可能是合理的.
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