Flare-up of hand osteoarthritis caused by zoledronic acid infusion
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- Werner de Castro, G.R., Neves, F.S., de Magalhães Souza Fialho, S.C. et al. Osteoporos Int (2010) 21: 1617. doi:10.1007/s00198-009-1123-7
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Zoledronic acid is effective for osteoporosis at a single annual intravenous dose. It usually causes few adverse effects; the most common are related to acute phase reactions. We reported the case of a 64-year-old woman who presented flare-up of hand osteoarthritis after zoledronic acid infusions. Despite the fact that arthralgia is a common side effect of intravenous bisphosphonates, development of inflammatory signs in osteoarthritic joints is a rare event. We hypothesized that this side effect is caused by a release of cytokines secondary to activation of gamma-delta T lymphocytes.