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Orbital Inflammatory Disease After Pamidronate Treatment for Metastatic Prostate Cancer
Arch Ophthalmol. 2003;121:1335-1336.
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Pamidronate sodium is a bisphosphonate drug used to inhibit bone reabsorption in the treatment of the hypercalcemia of malignancy, Paget disease of bone, and osteolytic bone metastases. It is administered as a slow intravenous infusion and is excreted renally. Although its mechanism of action is incompletely understood, it inhibits osteoclastic activity in vitro and binds directly to hydroxyapatite within the bone matrix.
The most common adverse effects of pamidronate infusion are nausea and anorexia. Ocular adverse effects are rare but include conjunctivitis, anterior uveitis, episcleritis, and scleritis.1-2 One case of orbital inflammation occurring 6 days after pamidronate treatment has been reported.3 Most of these patients had Paget disease of bone, which generally requires higher and more frequent doses of the drug.
We describe 2 patients who developed orbital inflammation after treatment with pamidronate for bone-involving metastases and discuss the implications both for the drug's mechanism of action and for the . . . [Full Text of this Article] Report of Cases
Comment
Prem S. Subramanian, MD, PhD;
John B. Kerrison, MD;
Preston C. Calvert, MD;
Neil R. Miller, MD
Baltimore, Md
Corresponding author: Prem S. Subramanian, MD, PhD, Wilmer Eye Institute, Maumenee B109, The Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287 (e-mail: psubram1@jhmi.edu).
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