ALENDRONATE-INDUCED RESPIRATORY DISTRESS
Respiratory distress is a rare adverse effect of alendronate that is typically associated with severe dyspnoea and wheezing and typically requires hospitalization. The patient with a history of dyspnoea and wheezing during the strenuous workload was treated promptly with alendronate for newly diagnosed osteoporosis. After 2 days, respiratory distress complications were restarted and we accurately reported the patient with basophilia, elevated immunoglobulin E (with a blood test), and allergic bronchopulmonary aspergillosis (with computed tomography scan image). The prospective patient was adequately understood as alendronate-induced respiratory distress with an unfortunate rechallenge method. Although there is no direct causal relationship from this adverse case report, the possible mechanism has discussed typically based on peer-reviewed literature.
2. Russell RG, Watts NB, Ebetino FH, Rogers MJ. Mechanisms of action of bisphosphonates: Similarities and differences and their potential influence on clinical efficacy. Osteoporos Int 2008;19:733-59.
3. Burstein HJ, Elias AD, Rugo HS, Coleigh MA, Wolff AC, Eisenberg PD, et al. Phase II study of sunitinib malate, an oral multitargeted tyrosine kinase inhibitor, in patients with metastatic breast cancer previously treated with an anthracycline and a taxane. J Clin Oncol 2008;26:1810-6.
4. Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method of estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981;30:239-45.
5. Endo Y, Nakamura M, Kikuchi T, Shinoda H, Takedu Y, Nitta Y, et al. Aminoalkylbisphosphonates, potent inhibitors of bone resorption, induce a prolonged stimulation of histamine synthesis and increase macrophages, granulocytes, and osteoclasts in vivo. Calcif Tissue Int 1993;52:248-54.
6. Funayama H, Mayanagi H, Takada H, Endo Y. Elevation of histidine decarboxylase activity in the mandible of mice by Prevotella intermedia lipopolysaccharide and its augmentation by an aminobisphosphonate. Arch Oral Biol 2000;45:787-95.
7. Deng X, Zhiqian Y, Funayama H, Shoji N, Sasano T, Iwakura Y, et al. Mutual augmentation of the induction of the histamine-forming enzyme, histidine decarboxylase, between alendronate and immuno-stimulants (IL-1, TNF, and LPS), and its prevention by clodronate. Toxicol Appl Pharmacol 2006;213:64-73.
8. Anthony JR, Paul AG, Jacob JP, Roy P. Hyperreactivity of mediator-releasing cells from patients with allergic bronchopulmonary aspergillosis as evidenced by basophil histamine release. J Allergy Clin Immunol 1983;72:386-92.
9. Rolla G, Bucca C, Brussino L. Bisphosphonate-induced bronchoconstriction in aspirin-sensitive asthma. Lancet 1994;343:426-7.
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