Zoledronate-Induced Large Vessel Vasculitis Diagnosed by PET/CT

D. Shchekochikhin, O. Vinogradskaya, Evgeniia Bublik, M. Shmyreva, G. Koroba, A. Farmanov, I. Aslanidis, D. Pursanova, Veronica Manukova, A. Zilov, A. Zhivov
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Abstract

Bisphosphonates remain a first-line treatment for osteoporosis. The most-widely used is zoledronate, which is well tolerated by most patients, but may rarely cause acute inflammatory reactions, which resemble those of large vessel vasculitis (LVV). We report a third case of LVV associated with zoledronic acid infusion, presenting with a 2-week history of fever up to 40 °C, flu-like symptoms, left jaw pain, myalgia, arthralgia, ankle stiffness in the morning, and intermittent claudication, diagnosed by the hybrid imaging modality 18F-FDG PET/CT with isolated lower extremity involvement and successfully treated with glucocorticoids.
PET/CT诊断唑来膦酸盐诱导的大血管炎
双膦酸盐仍然是治疗骨质疏松症的一线药物。最广泛使用的是唑来膦酸钠,大多数患者耐受性良好,但很少引起急性炎症反应,类似于大血管炎(LVV)。我们报告了第三例左室静脉曲张与唑来膦酸输液相关的病例,表现为2周的发热高达40°C,流感样症状,左颌疼痛,肌痛,关节痛,早晨踝关节僵硬,间歇性跛行,通过混合成像模式18F-FDG PET/CT诊断,孤立下肢受累,并成功治疗糖皮质激素。
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