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Title: Voriconazole-induced periostitis in a patient with overlap syndromes.
Authors: Hirota, Keisho
Yasoda, Akihiro  kyouindb  KAKEN_id
Fujii, Toshihito  kyouindb  KAKEN_id
Inagaki, Nobuya  kyouindb  KAKEN_id
Author's alias: 八十田, 明宏
Issue Date: 5-Mar-2014
Publisher: BMJ Publishing Group
Journal title: BMJ case reports
Volume: 2014
Abstract: A 52-year-old woman with overlap syndrome and interstitial pneumonia underwent immunosuppressive therapy and she was suspected to suffer from pulmonary aspergillosis. Oral voriconazole was initiated, and a rapid elevation of alkaline phosphatase (ALP) occurred after 4 weeks. After 2 months, the patient presented diffuse pain in bilateral skeletal regions, and bone scintigraphy revealed bilateral multiple areas of increased radiotracer uptake. We suspected the skeletal involvement as voriconazole-induced periostitis. Actually, the plasma fluoride level was increased. Voriconazole was replaced with itraconazole, and after 3 weeks, the patient stopped complaining of bone pain concomitant with the decrease in ALP. Voriconazole-induced periostitis is a rare condition but had previously been reported in solid organ or patients with bone marrow transplant who received a long-term voriconazole therapy. Our present case is distinctive of previous ones, because it occurred in a patient with connective tissue disease which had its rapid progression.
Rights: This article has been accepted for publication in BMJ Case Reports following peer review. The definitive copyedited, typeset version [Keisho Hirota, Akihiro Yasoda, Toshihito Fujii, Nobuya Inagaki. Voriconazole-induced periostitis in a patient with overlap syndromes. BMJ Case Reports 2014; doi:10.1136/bcr-2013-203485] is available online at:
この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。This is not the published version. Please cite only the published version.
DOI(Published Version): 10.1136/bcr-2013-203485
PubMed ID: 24599432
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