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Journal ArticleDOI

Voriconazole-induced periostitis causing arthralgias mimicking a flare of granulomatosis with polyangiitis.

Heather Gladue, +1 more
- 01 Dec 2013 - 
- Vol. 19, Iss: 8, pp 444-445
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TLDR
A case of voriconazole-induced periostitis that occurred in a 68-year-old woman with granulomatosis with polyangiitis is described, which may cause severe arthralgias that can mimic a flare of rheumatic diseases.
Abstract
We describe a case of voriconazole-induced periostitis that occurred in a 68-year-old woman with granulomatosis with polyangiitis. Our patient presented with months of severe hip pain limiting her daily activities, which was initially felt to be a flare of her granulomatosis with polyangiitis. However, upon further review, she had an elevated alkaline phosphatase and periostitis on her hip radiograph; voriconazole was held, and within 2 days she had marked improvement in her pain. Although this clinical syndrome is well documented in transplant patients, it is a rare complication in patients with autoimmune disorders. However, it is important because it may cause severe arthralgias that can mimic a flare of rheumatic diseases.

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Citations
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Journal ArticleDOI

Plasma fluoride level as a predictor of voriconazole induced periostitis in patients with skeletal pain

TL;DR: High plasma fluoride levels coupled with skeletal pain among patients who are on long-term voriconazole therapy is highly suggestive of periostitis.
Journal ArticleDOI

Voriconazole-induced periostitis: a new rheumatic disorder

TL;DR: Periostitis is increasingly reported and should be considered in patients taking voriconazole who present with bone pain and/or alkaline phosphatase elevation as rheumatologists are likely to be called to see such patients, a review of reported cases was undertaken.
Journal ArticleDOI

Voriconazole-induced periostitis in a patient with overlap syndromes.

TL;DR: A 52-year-old woman with overlap syndrome and interstitial pneumonia underwent immunosuppressive therapy and she was suspected to suffer from pulmonary aspergillosis, and oral voriconazole was initiated, and a rapid elevation of alkaline phosphatase occurred after 4 weeks.
Journal ArticleDOI

An update on drug-induced arthritis.

TL;DR: Recognizing that joint symptoms may, in fact, be drug-related not only saves time and unnecessary investigations but can also prevent needless suffering and morbidity due to late recognition of a drug-induced arthritic condition.
Journal ArticleDOI

Voriconazole-associated soft tissue ossification: an undescribed cause of glenohumeral joint capsulitis.

TL;DR: A case of voriconazole-associated periostitis, capsular and enthesial ossification and glenuhumeral capsulitis in a patient with a hematologic malignancy is presented.
References
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Journal ArticleDOI

Pulmonary aspergillosis: a clinical update

TL;DR: A clinical update on the epidemiology, risk factors, clinical presentation, diagnosis and management of the major syndromes associated with pulmonary aspergillosis is provided.
Journal ArticleDOI

Fluoride Excess and Periostitis in Transplant Patients Receiving Long-Term Voriconazole Therapy

TL;DR: Voriconzole is associated with painful periostitis, exostoses, and fluoride excess in post-transplant patients with long-term voriconazole use and cessation of vorIconazole therapy led to improvement in pain and reduced fluoride and alkaline phosphatase levels.
Journal ArticleDOI

Reversible skeletal disease and high fluoride serum levels in hematologic patients receiving voriconazole.

TL;DR: It is concluded that serum fluoride levels were elevated on average 5-fold above normal levels in hematologic patients receiving voriconazole, and Clinically relevant skeletal disease was associated with renal insufficiency and above 10-fold elevated fluoride levels, and was reversible on termination of vorIconazole treatment.
Journal ArticleDOI

Periostitis secondary to prolonged voriconazole therapy in lung transplant recipients.

TL;DR: awareness of this potential syndrome, which manifests as bone pain, elevated serum alkaline phosphatase and a bone scan suggestive of periostitis, is necessary in LT recipients on long‐term voriconazole.
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