Rituximab as a trigger factor of medication-related osteonecrosis of the jaw. A case report - 24/05/20
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Abstract |
Rituximab, an anti-CD20 monoclonal antibody, is an effective treatment for rheumatoid arthritis. Here we report the case of a patient with rheumatoid arthritis, having taken risedronate for 14 months to prevent corticosteroid-induced osteoporosis, more than 2 years ago, who presented osteonecrosis of jaw following herpetic gingivostomatitis two weeks after the beginning of a rituximab treatment associated with her usual anti-rheumatic drugs. Eight weeks later, no bone and/or gum healing was observed and a stage 2 medication-related osteonecrosis of the jaw (MRONJ) was diagnosed. A conservative approach was decided with antiseptic mouth washes, low-level laser treatment (LLLT) and systemic therapy with teriparatide. Complete mucosal coverage was obtained after more two years of follow-up. We suggest that rituximab as immunosuppressant might be a cause or a decompensating factor of MRONJ. Non-surgical periodontal treatment with LLLT and teriparatide are candidates for the treatment of MRONJ.
Le texte complet de cet article est disponible en PDF.Keywords : Rituximab, Medication-related osteonecrosis of the jaw, Herpetic gingivostomatitis, Low-level laser therapy, Teriparatide
Plan
Vol 121 - N° 3
P. 300-304 - juin 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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