Voriconazole-induced periostitis

Submitted: 11 November 2020
Accepted: 23 January 2021
Published: 19 April 2021
Abstract Views: 3747
PDF: 730
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Voriconazole is a fluorinated drug from the triazole group that is widely used in the prophylaxis and treatment of fungal infections in immunosuppressed patients. Chronic use of this medication can generate, as an adverse effect, a multifocal, asymmetric, diffuse and nodular periosteal reaction, associated with severe and disabling skeletal pain and elevated alkaline phosphatase and serum fluoride. Radiography is the imaging technique of choice for periostitis diagnosis. In general, clinical manifestations and radiographic findings disappear, when the drug is discontinued. We report the clinical case of a 44 year-old woman diagnosed with acute myeloid leukemia, who developed an invasive fungal infection treated with voriconazole after a stem cell transplant. Nine months after starting antifungal treatment, she manifested symptoms and radiological signs compatible with periostitis. Due to clinical suspicion, we decided to suspend voriconazole, with consequent resolution of clinical manifestations and radiological findings.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Levine MT, Chandrasekar PH. Adverse effects of voriconazole: Over a decade of use. Clin Transplant. 2016; 30: 1377-86. DOI: https://doi.org/10.1111/ctr.12834
Gayan Belmonte MJ, Botía González CM, García Gerónimo A, et al. Voriconazole-induced periostitis: radiological clues for its diagnosis. J Clin Rheumatol. 2019; 25: E67. DOI: https://doi.org/10.1097/RHU.0000000000000646
Skaug M, Spak C, Oza U. Painful periostitis in the setting of chronic voriconazole therapy. Baylor Univ Med Cent Proc. 2014; 27: 350-2. DOI: https://doi.org/10.1080/08998280.2014.11929156
Benitez LL, Carver PL. Adverse effects associated with long-term administration of azole antifungal agents. Drugs [Internet]. 2019; 79: 833-53. DOI: https://doi.org/10.1007/s40265-019-01127-8
Adwan MH. Voriconazole-induced periostitis: a new rheumatic disorder. Clin Rheumatol [Internet]. 2017; 36: 609-15. DOI: https://doi.org/10.1007/s10067-016-3341-7
Rad B, Saleem M, Grant S, et al. Fluorosis and periostitis deformans as complications of prolonged voriconazole treatment. Ann Clin Biochem. 2015; 52: 611-4. DOI: https://doi.org/10.1177/0004563214568873
. Geneva WHO. WHO (2010). Preventing disease through healthy environments inadequate or excess fluoride: a major public health concern [Internet]. [cited 2020 Nov 7]. Available from: https://www.who.int/ipcs/features/fluoride.pdf?ua=1
Tan I, Lomasney L, Stacy GS, et al. Spectrum of voriconazole-induced periostitis with review of the differential diagnosis. Am J Roentgenol. 2019; 212: 157-65. DOI: https://doi.org/10.2214/AJR.18.19991
Gerber B, Guggenberger R, Fasler D, et al. Reversible skeletal disease and high fluoride serum levels in hematologic patients receiving voriconazole. Blood. 2012; 120: 2390-4. DOI: https://doi.org/10.1182/blood-2012-01-403030
Moon WJ, Scheller EL, Suneja A, et al. Plasma fluoride level as a predictor of voriconazole-induced periostitis in patients with skeletal pain. Clin Infect Dis. 2014; 59: 1237-45. DOI: https://doi.org/10.1093/cid/ciu513
Elmore S, Wisse A, Chapin RW, Whelan TP, Silver RM. Voriconazole-associated periostitis presenting as hypertrophic osteoarthropathy following lung transplantation report of two cases and review of the literature. Semin Arthritis Rheum. 2019; 49: 319-23. DOI: https://doi.org/10.1016/j.semarthrit.2019.04.003
Yap FY, Skalski MR, Patel DB, et al. Hypertrophic osteoarthropathy: clinical and imaging features. Radiographics. 2017; 37: 157-75. DOI: https://doi.org/10.1148/rg.2017160052

How to Cite

Fernández Ávila, D., Diehl, M., Degrave, A., Buttazzoni, M., Pereira, T., Aguirre, M., … Scolnik, M. (2021). Voriconazole-induced periostitis. Reumatismo, 73(1), 44–47. https://doi.org/10.4081/reumatismo.2021.1368

Similar Articles

<< < 20 21 22 23 24 25 26 27 28 29 > >> 

You may also start an advanced similarity search for this article.