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Acute bilateral uveitis and right macular edema induced by a single infusion of zoledronic acid for the treatment of postmenopausal osteoporosis as a substitution for oral alendronate: a case report

Overview of attention for article published in BMC Musculoskeletal Disorders, February 2016
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Title
Acute bilateral uveitis and right macular edema induced by a single infusion of zoledronic acid for the treatment of postmenopausal osteoporosis as a substitution for oral alendronate: a case report
Published in
BMC Musculoskeletal Disorders, February 2016
DOI 10.1186/s12891-016-0926-x
Pubmed ID
Authors

Yiming Tian, Rui Wang, Lianyuan Liu, Chunming Ma, Qiang Lu, Fuzai Yin

Abstract

Zoledronic acid-induced uveitis (ZAIU) is rare but severe, and has been recently considered part of an acute phase reaction. Only 15 cases have been reported since 2005. Here we describe a case with macular edema, which is the first reported case observed after long-term alendronate tolerance. A 63-year-old Asian woman received her first intravenous zoledronic acid treatment for the management of postmenopausal osteoporosis as a more convenient substitute for oral alendronate. Twenty-four hours later, bilateral eye irritations, periorbital swelling, blurred vision, and diplopia presented. The complete blood count and transaminase levels were normal, but the erythrocytic sedimentation, C-reactive protein, and serum C4 levels were elevated. On detailed ophthalmological examination, a diagnosis of bilateral acute uveitis and macular edema in the right eye was made. The ocular symptoms were not improved until administration of topical and oral steroids. Complete resolution was achieved. There was no rechallenge of bisphosphonates, and no recurrence at 6 months follow-up. Based on an extensive review, abnormal fundus is rarely reported, especially in cases of macular edema. Rechallenge with zoledronic acid in five cases induced no additional uveitis, and changing the medication to pamidronate in another patient was also tolerated. Interestingly, our patient suffered from uveitis soon after intravenous zoledronate exposure after a two-year tolerance to oral alendronate. This is the first report of zoledronic acid induced uveitis with macular edema after long-term alendronate tolerance. Prior oral alendronate may not entirely prevent ZAIU. Steroids are usually necessary in the treatment of ZAIU. Bisphosphonate rechallenge is not fully contraindicated, and prior steroid administration may be a more reasonable treatment choice according to the available evidence.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 33 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 33 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 6 18%
Other 4 12%
Student > Master 4 12%
Librarian 3 9%
Student > Postgraduate 2 6%
Other 3 9%
Unknown 11 33%
Readers by discipline Count As %
Medicine and Dentistry 15 45%
Pharmacology, Toxicology and Pharmaceutical Science 1 3%
Arts and Humanities 1 3%
Nursing and Health Professions 1 3%
Biochemistry, Genetics and Molecular Biology 1 3%
Other 0 0%
Unknown 14 42%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 February 2016.
All research outputs
#18,443,697
of 22,851,489 outputs
Outputs from BMC Musculoskeletal Disorders
#3,133
of 4,049 outputs
Outputs of similar age
#290,297
of 400,586 outputs
Outputs of similar age from BMC Musculoskeletal Disorders
#64
of 82 outputs
Altmetric has tracked 22,851,489 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 4,049 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.1. This one is in the 10th percentile – i.e., 10% of its peers scored the same or lower than it.
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We're also able to compare this research output to 82 others from the same source and published within six weeks on either side of this one. This one is in the 6th percentile – i.e., 6% of its contemporaries scored the same or lower than it.