|Title:||Voriconazole-induced periostitis in a patient with overlap syndromes.|
|Author's alias:||八十田, 明宏|
|Publisher:||BMJ Publishing Group|
|Journal title:||BMJ case reports|
|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: http://casereports.bmj.com/content/2014/bcr-2013-203485.|
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|Appears in Collections:||Journal Articles |
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