TY - JOUR
T1 - Septic shock associated with denosumab-related osteonecrosis of the jaw
T2 - A case report and literature review
AU - Kouketsu, Atsumu
AU - Hashimoto, Wataru
AU - de la Cruz, Gerardo Martinez
AU - Takahashi, Tetsu
N1 - Publisher Copyright:
© 2015 Asian AOMS, ASOMP, JSOP, JSOMS, JSOM, and JAMI.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Denosumab is commonly used as an alternative to bisphosphonates (BPs) in patients with bone metastases, osteoporosis, and other similar diseases; however both BPs and denosumab can cause osteonecrosis of the jaw (ONJ). We report here a rare case of septic shock associated with denosumab-related ONJ in a 71-year-old woman who is potentially having breast cancer with metastases to several bones. She was given monthly subcutaneous injections of 120 mg denosumab to treat the metastases for 14 months after extraction of the mandibular right second molar. She exhibited decreased consciousness and was admitted under emergency. Clinical examination revealed disturbance of consciousness, hypotonia, and an area of exposed necrotic bone with pyorrhea on the right side of the mandible. Following a clinical diagnosis of septic shock associated with acute suppurative osteomyelitis in the right mandible as a result of denosumab-related ONJ, antibiotic and fluid therapy were performed to the sepsis. As the vital signs and laboratory results improved, the patient's general condition and level of consciousness were ameliorated; consequently she was discharged after 27 days of hospitalization. The patient has shown no subsequent evidence of recurrence for 1 year and 2 months after the treatment.
AB - Denosumab is commonly used as an alternative to bisphosphonates (BPs) in patients with bone metastases, osteoporosis, and other similar diseases; however both BPs and denosumab can cause osteonecrosis of the jaw (ONJ). We report here a rare case of septic shock associated with denosumab-related ONJ in a 71-year-old woman who is potentially having breast cancer with metastases to several bones. She was given monthly subcutaneous injections of 120 mg denosumab to treat the metastases for 14 months after extraction of the mandibular right second molar. She exhibited decreased consciousness and was admitted under emergency. Clinical examination revealed disturbance of consciousness, hypotonia, and an area of exposed necrotic bone with pyorrhea on the right side of the mandible. Following a clinical diagnosis of septic shock associated with acute suppurative osteomyelitis in the right mandible as a result of denosumab-related ONJ, antibiotic and fluid therapy were performed to the sepsis. As the vital signs and laboratory results improved, the patient's general condition and level of consciousness were ameliorated; consequently she was discharged after 27 days of hospitalization. The patient has shown no subsequent evidence of recurrence for 1 year and 2 months after the treatment.
KW - Denosumab
KW - Osteonecrosis
KW - Septic shock
UR - http://www.scopus.com/inward/record.url?scp=84950119629&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84950119629&partnerID=8YFLogxK
U2 - 10.1016/j.ajoms.2015.10.003
DO - 10.1016/j.ajoms.2015.10.003
M3 - Article
AN - SCOPUS:84950119629
SN - 2212-5558
VL - 28
SP - 228
EP - 233
JO - Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology
JF - Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology
IS - 3
ER -
